Clay Michael Marvin, FNP
Individual provider Active NPI Family Nurse Practitioner · Union City, TN
NPI 1992397657 · NPPES record last updated Feb 4, 2021
Key facts
- NPI
- 1992397657
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 28845 (TN)
- Practice address
- 1509 E Reelfoot Ave
Union City, TN 38261-5845 - Phone
- (741) 886-8662
- NPI assigned
- Feb 4, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Christian Family Medicine, LLC
Practice addresses (Care Compare)
189 Mount Pelia Rd
Martin, TN 38237-3811
Phone (731) 281-4760
Hospital & facility affiliations
- Tennessee Quality Care - Home Health
- Volunteer Community Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210305000853 | TN | Practitioner - Nurse Practitioner | 6204242894 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28845 | TN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Christian Family Medicine, LLC | Current |
Accepting new patients | |
| Upperline Healthcare, PC | Current |
Accepting new patients | |
| Upperline Healthcare, PC | Current |
Accepting new patients | |
| Dyersburg Family Walk-in Clinic LLC | Current |
Accepting new patients | |
| Independent Radiology Associates PLC | Past |
Accepting new patients |
Locations
7348 E Brainerd Rd
Chattanooga, TN 37421
Phone (205) 822-8038
1954 Saint John Ave
Ste 1
Dyersburg, TN 38024
Phone (731) 285-6110
2017 Saint John Ave
Ste B
Dyersburg, TN 38024
Phone (731) 285-6110
189 Mount Pelia Rd
Martin, TN 38237
Phone (731) 281-4760
79 Highway 51 S
Ripley, TN 38063
Phone (731) 635-8189
1509 E Reelfoot Ave
Union City, TN 38261
Phone (731) 886-1113
1516 E Reelfoot Ave
Union City, TN 38261
Phone (731) 886-8662
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 28845 | TN | Yes |
Addresses
Primary practice location
1509 E Reelfoot Ave
Union City, TN 38261-5845
Mailing address
PO Box 1132
Martin, TN 38237-1132
Phone (731) 695-0554
Other providers in Union City, TN
- Magnolia Ridge Care & Rehabilitation LLC
- Harbans Lal Malik
- Paul Joseph Marsidi
- Ashley Martin
- Marvin Asbury Blanton III MD PC
- Sandra E McGrath
- Cathy Hill McKinney
- Memphis Orthopaedic Medical Supplies, LLC
- Sere Catherine Merriman
- Michael L Bobo, DDS, MD, PSC
All providers in Union City, TN · Family Nurse Practitioner in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 4, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.