| Firsthand Health Of Tennessee | |
|
524 Broadway Fl 11 New York NY 10012-4471 | |
| (844) 378-4263 | |
| Not Available |
| Full Name | Firsthand Health Of Tennessee |
|---|---|
| Speciality | General Practice |
| Location | 524 Broadway Fl 11, New York, New York |
| Authorized Official Name and Position | Joe Parks (INCORPORATOR) |
| Authorized Official Contact | 5738648733 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Firsthand Health Of Tennessee 524 Broadway Fl 11 New York NY 10012-4471 Ph: (844) 378-4263 | Firsthand Health Of Tennessee 524 Broadway Fl 11 New York NY 10012-4471 Ph: (844) 378-4263 |
| NPI Number | 1477216539 |
|---|---|
| Provider Enumeration Date | 10/15/2021 |
| Last Update Date | 12/28/2023 |
| Certification Date | 12/28/2023 |
| Medicare PECOS PAC ID | 4284028002 |
|---|---|
| Medicare Enrollment ID | O20220221002190 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477216539 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Paul A Miranda |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1285659144 PECOS PAC ID: 3678510492 Enrollment ID: I20070223000666 |
| Provider Name | Adam Black |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558626689 PECOS PAC ID: 2961659586 Enrollment ID: I20130618000109 |
| Provider Name | Amanda Wright-brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982013751 PECOS PAC ID: 8921229584 Enrollment ID: I20141023001146 |
| Provider Name | Kimberly Vann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699170019 PECOS PAC ID: 1456662469 Enrollment ID: I20150617002127 |
| Provider Name | Ashlee Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962874230 PECOS PAC ID: 4880941012 Enrollment ID: I20180719001687 |
| Provider Name | Kandace Dalton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417430190 PECOS PAC ID: 1557615465 Enrollment ID: I20181113000824 |
| Provider Name | Davis M Stephen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750769154 PECOS PAC ID: 3577853183 Enrollment ID: I20190111000684 |
| Provider Name | Joseph Parks |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1003898495 PECOS PAC ID: 5496668204 Enrollment ID: I20220221002226 |
| Provider Name | Logan Edwards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235796285 PECOS PAC ID: 7810341450 Enrollment ID: I20230929002104 |
| Provider Name | Tera Howard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174081632 PECOS PAC ID: 1355776543 Enrollment ID: I20240118003752 |
| Provider Name | Sharine Wishart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548207335 PECOS PAC ID: 3274601752 Enrollment ID: I20241129000136 |
| Provider Name | Tabitha Rutter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881942233 PECOS PAC ID: 6002139169 Enrollment ID: I20241218003641 |
| Provider Name | Melissa Broughton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376153494 PECOS PAC ID: 2264847649 Enrollment ID: I20250204003386 |
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