Proxima Centauri, Pllc is a medicare enrolled "Clinic/center - Pain" provider in Manchester, Tennessee. Their current practice location is
1600 Mcarthur St, Manchester, Tennessee. You can reach out to their office (for appointments etc.) via phone at
(931) 723-7950.
Proxima Centauri, Pllc is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Proxima Centauri, Pllc
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1982972857.
Healthcare Provider's Profile
| Full Name | Proxima Centauri, Pllc |
|---|
| Type | Facility |
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| Speciality | Clinic/center - Pain |
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| Location | 1600 Mcarthur St, Manchester, Tennessee |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1982972857
- Provider Enumeration Date: 12/07/2011
- Last Update Date: 10/31/2012
Medicare PECOS Information:
- PECOS PAC ID: 9436326667
- Enrollment ID: O20120111000573
Medical Identifiers
Medical identifiers for Proxima Centauri, Pllc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1982972857 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 111N00000X | Chiropractor | (* (Not Available)) | Secondary |
| 261QP3300X | Clinic/center - Pain | (* (Not Available)) | Primary |
| 363AM0700X | Physician Assistant - Medical | (* (Not Available)) | Secondary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Proxima Centauri, Pllc acts as a billing entity for following providers:
| Provider Name | James E Roth |
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| Provider Type | Practitioner - Anesthesiology |
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| Provider Identifiers | NPI Number: 1437105608
PECOS PAC ID: 1557263316
Enrollment ID: I20081006000352 |
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| Provider Name | Jana M Stovall |
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| Provider Type | Practitioner - Nurse Practitioner |
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| Provider Identifiers | NPI Number: 1811317068
PECOS PAC ID: 0042432544
Enrollment ID: I20141118002027 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Proxima Centauri, Pllc is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Proxima Centauri, Pllc
Po Box 437,
Manchester, TN 37349-0437
Ph: (931) 723-7950 | Proxima Centauri, Pllc
1600 Mcarthur St,
Manchester, TN 37355-2522
Ph: (931) 723-7950 |
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