| Copilotiq, Pc | |
|
40 Burton Hills Blvd Ste 200 Nashville TN 37215-5902 | |
| (615) 380-4003 | |
| Not Available |
| Full Name | Copilotiq, Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 40 Burton Hills Blvd Ste 200, Nashville, Tennessee |
| Authorized Official Name and Position | Alice Greene (PHYSICIAN) |
| Authorized Official Contact | 6153804003 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Copilotiq, Pc 40 Burton Hills Blvd Ste 200 Nashville TN 37215-5902 Ph: (615) 380-4003 | Copilotiq, Pc 40 Burton Hills Blvd Ste 200 Nashville TN 37215-5902 Ph: (615) 380-4003 |
| NPI Number | 1316527203 |
|---|---|
| Provider Enumeration Date | 04/13/2021 |
| Last Update Date | 12/04/2023 |
| Medicare PECOS PAC ID | 7810392040 |
|---|---|
| Medicare Enrollment ID | O20210825002791 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316527203 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Stacy Wason-fawver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194143347 PECOS PAC ID: 2466672142 Enrollment ID: I20140930002729 |
| Provider Name | Sarah Goodrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366831778 PECOS PAC ID: 7416278700 Enrollment ID: I20150611003171 |
| Provider Name | Afeni Henderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932572443 PECOS PAC ID: 1850694035 Enrollment ID: I20160121001651 |
| Provider Name | Latoya Hopkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962954388 PECOS PAC ID: 9931489762 Enrollment ID: I20161213000888 |
| Provider Name | Sophia Molavi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528782067 PECOS PAC ID: 0749654994 Enrollment ID: I20230329003510 |
| Provider Name | Alice Greene |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710903638 PECOS PAC ID: 9739218140 Enrollment ID: I20240607002459 |
| Provider Name | Amber Rose Bowser |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851614713 PECOS PAC ID: 1658541701 Enrollment ID: I20241025000948 |
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