Atoka Idaville Family Health, Inc

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

13123 Issued in TN

Legal business name

ATOKA IDAVILLE FAMILY HEALTH, INC

Practice address

5847 Atoka Idaville Rd
Brighton, TN 38011-7066

Phone

(901) 304-8709

NPI assigned

Feb 13, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Robyn Yvette Vanderford, FNP

Title

Owner/Provider

Phone

(901) 837-0701

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1455321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664496000000",
    "number": "1962861310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5847 ATOKA IDAVILLE RD",
            "city": "BRIGHTON",
            "state": "TN",
            "postal_code": "380117066",
            "telephone_number": "901-837-0701",
            "fax_number": "901-837-0703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5847 ATOKA IDAVILLE RD",
            "city": "BRIGHTON",
            "state": "TN",
            "postal_code": "380117066",
            "telephone_number": "901-304-8709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATOKA IDAVILLE FAMILY HEALTH, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-13",
        "last_updated": "2022-09-30",
        "certification_date": "2022-09-30",
        "status": "A",
        "authorized_official_last_name": "VANDERFORD",
        "authorized_official_first_name": "ROBYN",
        "authorized_official_middle_name": "YVETTE",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "901-837-0701",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "TN",
            "license": "13123",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "2007009643",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3703407",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Arthur Abbott, RBT
• John Biffle, M.S
• Morgan Kyrin Braden, RBT
• Campbell Bradley, RBT
• Brighton Family Medicine
• Brighton Medical Practice

• All providers in Brighton, TN
• Primary Care Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.