| Cogent Healthcare Of Tennessee, Pc | |
|
400 E Tickle St Dyersburg TN 38024-3120 | |
| (731) 285-2410 | |
| Not Available |
| Full Name | Cogent Healthcare Of Tennessee, Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 400 E Tickle St, Dyersburg, Tennessee |
| Authorized Official Name and Position | Melissa Harlan (DIRECTOR OF PAYER ENROLLMENT) |
| Authorized Official Contact | 6155776340 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cogent Healthcare Of Tennessee, Pc 5410 Maryland Way Suite 300 Brentwood TN 37027-5064 Ph: () - | Cogent Healthcare Of Tennessee, Pc 400 E Tickle St Dyersburg TN 38024-3120 Ph: (731) 285-2410 |
| NPI Number | 1952654246 |
|---|---|
| Provider Enumeration Date | 10/24/2012 |
| Last Update Date | 09/08/2021 |
| Medicare PECOS PAC ID | 8628221165 |
|---|---|
| Medicare Enrollment ID | O20130110000564 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952654246 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Ayodele A Olusanya |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932155868 PECOS PAC ID: 2163336264 Enrollment ID: I20031113000449 |
| Provider Name | Joseph B Ozenne |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083622575 PECOS PAC ID: 3072408855 Enrollment ID: I20040219000806 |
| Provider Name | Nicholas J Dieringer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124003561 PECOS PAC ID: 1850375981 Enrollment ID: I20040616000754 |
| Provider Name | Blal Ahmed Zafar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568421386 PECOS PAC ID: 2466437843 Enrollment ID: I20040621000743 |
| Provider Name | James Miller |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891738225 PECOS PAC ID: 6709798440 Enrollment ID: I20040629001359 |
| Provider Name | Don E Adams |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245215847 PECOS PAC ID: 6709866817 Enrollment ID: I20040721000138 |
| Provider Name | Donald G Polk |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1942294863 PECOS PAC ID: 5991776866 Enrollment ID: I20040804000351 |
| Provider Name | James T Poole |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851341291 PECOS PAC ID: 2062487564 Enrollment ID: I20040828000120 |
| Provider Name | James A Davis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184602898 PECOS PAC ID: 0547230096 Enrollment ID: I20040914000203 |
| Provider Name | Festus N Arinze |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114974086 PECOS PAC ID: 9133196223 Enrollment ID: I20040916001133 |
| Provider Name | Frank A Perry |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619917879 PECOS PAC ID: 9032178157 Enrollment ID: I20041005000869 |
| Provider Name | Sanford J Kim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891782454 PECOS PAC ID: 7113981747 Enrollment ID: I20041115000243 |
| Provider Name | Adejoke F. Aina-babalola |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669556148 PECOS PAC ID: 8426013376 Enrollment ID: I20041119001020 |
| Provider Name | Ouida Collins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033246640 PECOS PAC ID: 4385608686 Enrollment ID: I20041120000115 |
| Provider Name | Olusegun V Ategbole |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407805450 PECOS PAC ID: 5890753271 Enrollment ID: I20050103000163 |
| Provider Name | Kimberly A Russell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194753293 PECOS PAC ID: 7911932199 Enrollment ID: I20050927001410 |
| Provider Name | Darl V Bell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275538977 PECOS PAC ID: 5294718474 Enrollment ID: I20051222000714 |
| Provider Name | Charles A Ball |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154344836 PECOS PAC ID: 9537137401 Enrollment ID: I20060209000275 |
| Provider Name | Nena W Egli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376580613 PECOS PAC ID: 3779590328 Enrollment ID: I20060307000695 |
| Provider Name | Yaw Otchere-boateng |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881668937 PECOS PAC ID: 7911920236 Enrollment ID: I20060317000404 |
| Provider Name | Minesh N Shah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407947666 PECOS PAC ID: 4981604923 Enrollment ID: I20061222000094 |
| Provider Name | Mydhili Challa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528005097 PECOS PAC ID: 3375544422 Enrollment ID: I20070116000617 |
| Provider Name | Joaquina E Vides De Montoya |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598852857 PECOS PAC ID: 7012919418 Enrollment ID: I20070214000289 |
| Provider Name | Jaime E Montoya Chavez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083711535 PECOS PAC ID: 8820190879 Enrollment ID: I20070222000577 |
| Provider Name | Faiza Amin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790754646 PECOS PAC ID: 8921901497 Enrollment ID: I20070615000450 |
| Provider Name | Emmanuel I Obi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518960640 PECOS PAC ID: 4385557032 Enrollment ID: I20070920000199 |
| Provider Name | Kelley V Jefferson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154398105 PECOS PAC ID: 9335210616 Enrollment ID: I20080613000067 |
| Provider Name | Bert J Smith |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497839070 PECOS PAC ID: 4587738877 Enrollment ID: I20080805000250 |
| Provider Name | Retty Rachel Thomas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861560492 PECOS PAC ID: 1052374212 Enrollment ID: I20080902000155 |
| Provider Name | Ankur M Bant |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164544979 PECOS PAC ID: 9638232549 Enrollment ID: I20090120000105 |
| Provider Name | Shadi M.s. Ayyoub |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477674232 PECOS PAC ID: 5890881916 Enrollment ID: I20090305000455 |
| Provider Name | Larry Kevin Nash |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245221183 PECOS PAC ID: 4587620158 Enrollment ID: I20091109000364 |
| Provider Name | Tammy Lynn Ridley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992971238 PECOS PAC ID: 8729102843 Enrollment ID: I20100826000421 |
| Provider Name | Akberet B Hadgu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548471501 PECOS PAC ID: 1850588369 Enrollment ID: I20101209001030 |
| Provider Name | Jennifer Carlisle Mckeown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194024497 PECOS PAC ID: 8628252657 Enrollment ID: I20110415000012 |
| Provider Name | Michael Babb |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144298399 PECOS PAC ID: 8729067988 Enrollment ID: I20110719000512 |
| Provider Name | Brandon Lee Maroney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366726812 PECOS PAC ID: 8123291820 Enrollment ID: I20111025000282 |
| Provider Name | Al-muntaser Abu Ali |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891978235 PECOS PAC ID: 0840465399 Enrollment ID: I20111212000254 |
| Provider Name | Kathleen J Locker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578698270 PECOS PAC ID: 4082696968 Enrollment ID: I20120123000063 |
| Provider Name | Jaime R Bailey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053595348 PECOS PAC ID: 3375619497 Enrollment ID: I20120606000312 |
| Provider Name | Ashley L Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558652131 PECOS PAC ID: 1153599089 Enrollment ID: I20120730000695 |
| Provider Name | Michael C Brown |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386817468 PECOS PAC ID: 6002065083 Enrollment ID: I20121008000252 |
| Provider Name | Temeka R Tunstall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124382643 PECOS PAC ID: 3274782115 Enrollment ID: I20121009000336 |
| Provider Name | Evans N Mize |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831414358 PECOS PAC ID: 6709031750 Enrollment ID: I20130225000312 |
| Provider Name | Gabriela P Orozco |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891968061 PECOS PAC ID: 0143475491 Enrollment ID: I20130313000044 |
| Provider Name | Levi P Benson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053638148 PECOS PAC ID: 9830334176 Enrollment ID: I20130314000385 |
| Provider Name | Curt Bryant Charnes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588621817 PECOS PAC ID: 6002872272 Enrollment ID: I20130403000326 |
| Provider Name | Jason Mclavy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639245459 PECOS PAC ID: 7214993948 Enrollment ID: I20130528000568 |
| Provider Name | Chimalum Okafor |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982916763 PECOS PAC ID: 3476795410 Enrollment ID: I20130805000205 |
| Provider Name | Laura G Eaton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629400064 PECOS PAC ID: 8921242025 Enrollment ID: I20130911000286 |
| Provider Name | Mark A Clay |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417004136 PECOS PAC ID: 0143326322 Enrollment ID: I20130918000838 |
| Provider Name | Christopher L Lux |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346207255 PECOS PAC ID: 1850329111 Enrollment ID: I20140327001870 |
| Provider Name | Jody Allan Sanchez Junia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710065206 PECOS PAC ID: 1052312832 Enrollment ID: I20140423001442 |
| Provider Name | Fadwa Alhomoud |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528352937 PECOS PAC ID: 2163648577 Enrollment ID: I20140721001592 |
| Provider Name | Leopoldo Mario Basilico |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538480603 PECOS PAC ID: 7214150051 Enrollment ID: I20140821002098 |
| Provider Name | Heather H Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184050262 PECOS PAC ID: 2062633282 Enrollment ID: I20141031000413 |
| Provider Name | Whitney M Matchette |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831504323 PECOS PAC ID: 0446576151 Enrollment ID: I20150223001666 |
| Provider Name | Jennifer A Lay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508254350 PECOS PAC ID: 4789901646 Enrollment ID: I20150402001864 |
| Provider Name | Olukayode A Bamgbelu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164677845 PECOS PAC ID: 1557496965 Enrollment ID: I20150408001160 |
| Provider Name | Wally Folad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326331893 PECOS PAC ID: 8022237841 Enrollment ID: I20150422001782 |
| Provider Name | Melanie June Winegar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891182358 PECOS PAC ID: 1850602228 Enrollment ID: I20150625002498 |
| Provider Name | Tejasvi Kommula |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679832661 PECOS PAC ID: 9234442286 Enrollment ID: I20150720001814 |
| Provider Name | Loraine Ogbenyealu Achebe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073807582 PECOS PAC ID: 6507172434 Enrollment ID: I20150908002418 |
| Provider Name | Izuchukwu Iwueke |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568717734 PECOS PAC ID: 2567779614 Enrollment ID: I20150922001569 |
| Provider Name | Monal P Joshi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1396901997 PECOS PAC ID: 5890967061 Enrollment ID: I20151014003283 |
| Provider Name | Nitara D Carswell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194084822 PECOS PAC ID: 5890005110 Enrollment ID: I20151117000086 |
| Provider Name | Cathy Denise Abston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992172779 PECOS PAC ID: 0840590790 Enrollment ID: I20151124002674 |
| Provider Name | Amanda Collier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669857850 PECOS PAC ID: 2961703616 Enrollment ID: I20151222001519 |
| Provider Name | Md Saidur Rahman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407018070 PECOS PAC ID: 1254501141 Enrollment ID: I20160107001223 |
| Provider Name | Hollie J Coates-hensley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689050593 PECOS PAC ID: 8527182161 Enrollment ID: I20160114000987 |
| Provider Name | Jayanthi Samuel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952771941 PECOS PAC ID: 9537462775 Enrollment ID: I20160122000719 |
| Provider Name | William Tate |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205263266 PECOS PAC ID: 7810288511 Enrollment ID: I20160628001961 |
| Provider Name | Tiffany Renee Franklin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073958013 PECOS PAC ID: 8921248469 Enrollment ID: I20160816000663 |
| Provider Name | Everald Uriah Walker |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1922444363 PECOS PAC ID: 5991933327 Enrollment ID: I20160907001237 |
| Provider Name | Angela Arnold-ross |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548713191 PECOS PAC ID: 0941588693 Enrollment ID: I20161031002016 |
| Provider Name | Chintan Desai |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588008973 PECOS PAC ID: 1153632880 Enrollment ID: I20161202000670 |
| Provider Name | Laila Hubard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518415355 PECOS PAC ID: 3678853975 Enrollment ID: I20161202000686 |
| Provider Name | Mary R Mcnees |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043768435 PECOS PAC ID: 7719267426 Enrollment ID: I20170103001511 |
| Provider Name | Alvin D Thompson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891059499 PECOS PAC ID: 0749561496 Enrollment ID: I20170111002556 |
| Provider Name | Peter Hsu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003173592 PECOS PAC ID: 1557597176 Enrollment ID: I20170302000480 |
| Provider Name | Melody Stump |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578929899 PECOS PAC ID: 6709160948 Enrollment ID: I20170307000733 |
| Provider Name | Brittany Hill Slatton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083090682 PECOS PAC ID: 9638447113 Enrollment ID: I20170626001684 |
| Provider Name | David F Dougherty |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104261445 PECOS PAC ID: 2567603947 Enrollment ID: I20170915000976 |
| Provider Name | Asad A Al Aboud |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760725915 PECOS PAC ID: 4284924911 Enrollment ID: I20171031001515 |
| Provider Name | Sarah L Hood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932639317 PECOS PAC ID: 2062771918 Enrollment ID: I20180122002684 |
| Provider Name | Shervin Shahriari |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1053738203 PECOS PAC ID: 3375802176 Enrollment ID: I20180124003482 |
| Provider Name | Deanna R White |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063521292 PECOS PAC ID: 9234122623 Enrollment ID: I20180504002248 |
| Provider Name | Mosunmola A Ademosu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003234006 PECOS PAC ID: 1759654379 Enrollment ID: I20180612001202 |
| Provider Name | Janet George |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1477971828 PECOS PAC ID: 3072869114 Enrollment ID: I20180703002529 |
| Provider Name | Joellen B Edwards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447742259 PECOS PAC ID: 7911257761 Enrollment ID: I20180829001632 |
| Provider Name | Milner B Owens Staub |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609118058 PECOS PAC ID: 2567787765 Enrollment ID: I20180903000022 |
| Provider Name | Alexandra M Bowling |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1073996948 PECOS PAC ID: 5597063495 Enrollment ID: I20180905002536 |
| Provider Name | Christiana Bediako |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639551369 PECOS PAC ID: 1557664349 Enrollment ID: I20181001002300 |
| Provider Name | Oyedotun O Oyewole |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083001747 PECOS PAC ID: 6002168374 Enrollment ID: I20181015002462 |
| Provider Name | Sotonte Eresia Ebenibo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376958603 PECOS PAC ID: 3678840964 Enrollment ID: I20181017000798 |
| Provider Name | Megan J Bode |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194216184 PECOS PAC ID: 7719230838 Enrollment ID: I20181018002946 |
| Provider Name | Azaria C Ehlers |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1235516261 PECOS PAC ID: 1850640699 Enrollment ID: I20181106002696 |
| Provider Name | Hiltrud Thurmann |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881762730 PECOS PAC ID: 4082788096 Enrollment ID: I20181107002068 |
| Provider Name | Krista Nicole Bailey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477028256 PECOS PAC ID: 4385981018 Enrollment ID: I20190202000217 |
| Provider Name | Betty Abban |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1063893162 PECOS PAC ID: 1557609898 Enrollment ID: I20190213000365 |
| Provider Name | Christie L Henson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194293894 PECOS PAC ID: 3779821806 Enrollment ID: I20190717003683 |
| Provider Name | Yvonne T Pfanenstiel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295966968 PECOS PAC ID: 5092854786 Enrollment ID: I20190826003999 |
| Provider Name | Katlyn Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114406105 PECOS PAC ID: 5092147082 Enrollment ID: I20191113000282 |
| Provider Name | Tia Criscoe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184959066 PECOS PAC ID: 9032547054 Enrollment ID: I20200325000511 |
| Provider Name | Christy Bantong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598295826 PECOS PAC ID: 5799057188 Enrollment ID: I20200604003242 |
| Provider Name | Aundrea L Wallace |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053930404 PECOS PAC ID: 7911328463 Enrollment ID: I20200609001165 |
| Provider Name | Brittany L Crye |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043740558 PECOS PAC ID: 6103198437 Enrollment ID: I20200716003137 |
| Provider Name | Jennifer Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649801994 PECOS PAC ID: 5496179145 Enrollment ID: I20200728001308 |
| Provider Name | Stacey Buckner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801410253 PECOS PAC ID: 0345667986 Enrollment ID: I20200827003906 |
| Provider Name | Hannah Gump |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144823121 PECOS PAC ID: 6507272770 Enrollment ID: I20210312001654 |
| Provider Name | Amy Reagan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013585272 PECOS PAC ID: 0143360370 Enrollment ID: I20210712002096 |
| Provider Name | Victoria Robin Baker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952830309 PECOS PAC ID: 5890197693 Enrollment ID: I20210716000146 |
| Provider Name | Bilal Fiaz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740770759 PECOS PAC ID: 5294087235 Enrollment ID: I20210810001572 |
| Provider Name | Jorge Capella-gonzalez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093866808 PECOS PAC ID: 4688932635 Enrollment ID: I20211022000367 |
| Provider Name | Guo Phoenix |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396901062 PECOS PAC ID: 5597935643 Enrollment ID: I20211026003044 |
| Provider Name | Benjamin J Newcomb |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295229276 PECOS PAC ID: 6608201546 Enrollment ID: I20211117000857 |
| Provider Name | Eve Hyatt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720094592 PECOS PAC ID: 6002876216 Enrollment ID: I20211221001877 |
| Provider Name | Faraz Masood |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1609071661 PECOS PAC ID: 8426242066 Enrollment ID: I20220421002560 |
| Provider Name | Sanober Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275549529 PECOS PAC ID: 8729031620 Enrollment ID: I20220422000119 |
| Provider Name | Kartik Kailesh Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568786465 PECOS PAC ID: 2466693346 Enrollment ID: I20220422000366 |
| Provider Name | Renuka Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720374051 PECOS PAC ID: 0840514030 Enrollment ID: I20220422000587 |
| Provider Name | Sherif Latif |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518167188 PECOS PAC ID: 9830221233 Enrollment ID: I20220606000963 |
| Provider Name | Sean Arora |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841729449 PECOS PAC ID: 6305184342 Enrollment ID: I20220616000837 |
| Provider Name | Adnan Lakhani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871853671 PECOS PAC ID: 8628386539 Enrollment ID: I20220621001315 |
| Provider Name | Rachael Nambusi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003255985 PECOS PAC ID: 8729394267 Enrollment ID: I20220627001276 |
| Provider Name | Crystal L Tinch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790417624 PECOS PAC ID: 3870976855 Enrollment ID: I20220824001949 |
| Provider Name | Laeeq Butt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841684735 PECOS PAC ID: 2264719335 Enrollment ID: I20220824002915 |
| Provider Name | Jennifer Huffman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083334593 PECOS PAC ID: 4183000599 Enrollment ID: I20221007000551 |
| Provider Name | Vishnu Vardhan Madireddy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811063761 PECOS PAC ID: 2860597671 Enrollment ID: I20221025003048 |
| Provider Name | Kelechi Emmanuel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467015982 PECOS PAC ID: 8820326879 Enrollment ID: I20221121001431 |
| Provider Name | Kyaw Lin Aung |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669033866 PECOS PAC ID: 5698143295 Enrollment ID: I20221201000482 |
| Provider Name | Kiesha Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780262014 PECOS PAC ID: 7214306406 Enrollment ID: I20230109002687 |
| Provider Name | Madeline Gillon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427764398 PECOS PAC ID: 5092187625 Enrollment ID: I20230208002031 |
| Provider Name | Daisy-scarlett Maccallum |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508120924 PECOS PAC ID: 8628205705 Enrollment ID: I20230222002001 |
| Provider Name | Khacerrian Stanley Henderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134843527 PECOS PAC ID: 7911371364 Enrollment ID: I20230325000164 |
| Provider Name | Alexander Mathai |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104856608 PECOS PAC ID: 1759483209 Enrollment ID: I20230420001246 |
| Provider Name | Garrick Collins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487881439 PECOS PAC ID: 9234315409 Enrollment ID: I20230425000167 |
| Provider Name | Farman Ali |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437520301 PECOS PAC ID: 1951694165 Enrollment ID: I20230425000306 |
| Provider Name | Anne Petersen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043398613 PECOS PAC ID: 9234264656 Enrollment ID: I20230425000411 |
| Provider Name | Kenya Hanspard |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932170305 PECOS PAC ID: 9739072984 Enrollment ID: I20230425000647 |
| Provider Name | Elizabeth L Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073834693 PECOS PAC ID: 3072755651 Enrollment ID: I20230425000766 |
| Provider Name | Kara Marino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295141471 PECOS PAC ID: 1951521913 Enrollment ID: I20230726003544 |
| Provider Name | Melissa L Winton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053012989 PECOS PAC ID: 5597127340 Enrollment ID: I20230810004564 |
| Provider Name | Ljubomir Ilic |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750348843 PECOS PAC ID: 7113020439 Enrollment ID: I20230907001276 |
| Provider Name | Harirajan Mani |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205220506 PECOS PAC ID: 7618224213 Enrollment ID: I20230913002388 |
| Provider Name | Javed S Iqbal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649614462 PECOS PAC ID: 2769609957 Enrollment ID: I20231004002309 |
| Provider Name | Michael James Crotty |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215199559 PECOS PAC ID: 2668601576 Enrollment ID: I20231026002960 |
| Provider Name | Fernando Madero Gorostieta |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720219637 PECOS PAC ID: 2365608916 Enrollment ID: I20240117003410 |
| Provider Name | Poyani Desai |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902285141 PECOS PAC ID: 7113271438 Enrollment ID: I20240130000842 |
| Provider Name | Ifedolapo S Olanrewaju |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033465893 PECOS PAC ID: 2668764077 Enrollment ID: I20240131000277 |
| Provider Name | Ijeoma Arubaleze |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881081933 PECOS PAC ID: 2062768591 Enrollment ID: I20240131004262 |
| Provider Name | Emad Shoukry |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053318857 PECOS PAC ID: 1759353337 Enrollment ID: I20240202000560 |
| Provider Name | Savita Kurup |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568457968 PECOS PAC ID: 0840253399 Enrollment ID: I20240221003320 |
| Provider Name | Srinivas Katta |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841428752 PECOS PAC ID: 4385878412 Enrollment ID: I20240226002325 |
Hometown Urgent Care Of Dyersburg Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2550 Parr Ave, Dyersburg, TN 38024 Phone: 731-325-5678 | |
Mid-south Convenient Care, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1445 Us Highway 51 Byp E Ste B, Dyersburg, TN 38024 Phone: 731-286-1900 Fax: 731-286-1900 | |
Grace Family Practice Clinic, P.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1716 Parr Ave Ste D, Dyersburg, TN 38024 Phone: 731-288-0911 Fax: 731-288-0065 | |
Dyersburg Clinic Corp Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 E Tickle St, Dyersburg, TN 38024 Phone: 731-288-7250 Fax: 731-288-7258 | |
Bcp 1, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2490 Parr Ave Ste 9, Dyersburg, TN 38024 Phone: 731-285-0844 | |
Dyersburg Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 E Tickle St, Dyersburg, TN 38024 Phone: 731-287-2400 Fax: 731-285-9545 | |
Digestive Associates, P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1067 Vendall Rd, Dyersburg, TN 38024 Phone: 731-285-5133 Fax: 731-285-9921 |