Lynchburg Medical Clinic, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

47136 Issued in TN

Legal business name

LYNCHBURG MEDICAL CLINIC, LLC

Practice address

40 Lynchburg Hwy
Lynchburg, TN 37352-7449

Phone

(931) 759-4197

Fax

(931) 759-6673

NPI assigned

Dec 10, 2012

Organization subpart

No

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

Authorized official

Name

Brett L Ferrell, MDNPI 1356646434

Title

Member

Phone

(931) 454-0489

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lori Russell, P.A.

  • Medical Physician Assistant
  • Tullahoma, TN
  • NPI 1891798377

  TN

  Medicare reassignment
• Brett L Ferrell, M.D.

  • Family Medicine Physician
  • Tullahoma, TN
  • NPI 1356646434

  Family Medicine

  NPD (past) Authorized official

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

{
    "created_epoch": "1355097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364342400000",
    "number": "1982949434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WILLIAM NORTHERN BLVD",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373884754",
            "telephone_number": "931-454-0489",
            "fax_number": "931-454-1227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 LYNCHBURG HWY",
            "city": "LYNCHBURG",
            "state": "TN",
            "postal_code": "373527449",
            "telephone_number": "931-759-4197",
            "fax_number": "931-759-6673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYNCHBURG MEDICAL CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-10",
        "last_updated": "2013-03-27",
        "status": "A",
        "authorized_official_last_name": "FERRELL",
        "authorized_official_first_name": "BRETT",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "931-454-0489",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "47136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emma Gammill
• Robert W Gray, DPH
• Deborah Hart, PT
• Highlands Consulting LLC
• Lynchburg Family Medicine and Minor Emergency Center PC
• Lynchburg Medical Investors, LLC
• Judy Carol Merritt, MS, RD, LDN, CDE
• Metropolitan Lynchburg-Moore County
• Robert Price, PT
• Deadra Renea Quinn, APN

• All providers in Lynchburg, TN
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.