| Boones Creek Medical Pllc | |
| 
					2685 Boones Creek Road Suite 104 Johnson City TN 37615  | |
| (423) 282-0636 | |
| (423) 282-1990 | 
| Full Name | Boones Creek Medical Pllc | 
|---|---|
| Speciality | Family Medicine | 
| Location | 2685 Boones Creek Road, Johnson City, Tennessee | 
| Authorized Official Name and Position | Amber F Wilkinson (OWNER/ADMINISTRATOR) | 
| Authorized Official Contact | 4232820636 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Boones Creek Medical Pllc 1000 W Jackson Blvd Ste 5 Jonesborough TN 37659-5397 Ph: (423) 282-1990  | Boones Creek Medical Pllc 2685 Boones Creek Road Suite 104 Johnson City TN 37615 Ph: (423) 282-0636  | 
| NPI Number | 1871528976 | 
|---|---|
| Provider Enumeration Date | 07/11/2006 | 
| Last Update Date | 02/13/2020 | 
| Medicare PECOS PAC ID | 6507969631 | 
|---|---|
| Medicare Enrollment ID | O20070310000108 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1871528976 | NPI | - | NPPES | 
| 3735590 | Medicaid | TN | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary | 
| Provider Name | Mark J Wilkinson | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1588619738 PECOS PAC ID: 7416050547 Enrollment ID: I20070310000111  | 
| Provider Name | Amber F Wilkinson | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1053535211 PECOS PAC ID: 7214037902 Enrollment ID: I20070710000963  | 
| Provider Name | Elizabeth A Smith | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1962524017 PECOS PAC ID: 8628160652 Enrollment ID: I20070822001305  | 
| Provider Name | Michael J May | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1134585326 PECOS PAC ID: 4284931312 Enrollment ID: I20160404002212  | 
| Provider Name | Marissa Kirchenbauer | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1851890693 PECOS PAC ID: 2264793959 Enrollment ID: I20220909002511  | 
Mcc, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 501 E Watauga Ave, Johnson City, TN 37601 Phone: 423-722-8446 Fax: 423-722-5674  | |
Medical Education Assistance Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 917 W Walnut St, Johnson City, TN 37604 Phone: 423-439-6464 Fax: 423-439-7118  | |
Wyche & Wyche, M.d., P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2406 Susannah St, Johnson City, TN 37601 Phone: 423-282-2542 Fax: 423-282-5447  | |
Imperial Healthcare Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1604 Lamons Ln Ste 230, Johnson City, TN 37604 Phone: 423-930-5168 Fax: 423-328-0193  | |
New Life Chiropractic And Wellness Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 514 E Watauga Ave, Johnson City, TN 37601 Phone: 423-928-4101  | |
Blue Ridge Medical Management Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 310 N State Of Franklin Rd, Ste 301a, Johnson City, TN 37604 Phone: 423-431-6816 Fax: 423-431-2983  | |
State Of Franklin Healthcare Associates Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2528 Wesley St, Suite 2, Johnson City, TN 37601 Phone: 423-794-2430 Fax: 423-283-9719  |