| Exac Care, Llc | |
|
229 Interstate Dr Suite 103 Crossville TN 38555-2709 | |
| (931) 210-5577 | |
| (931) 210-5575 |
| Full Name | Exac Care, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 229 Interstate Dr, Crossville, Tennessee |
| Authorized Official Name and Position | Kenneth R Stephens (CHIEF EXECUTIVE OFFICE) |
| Authorized Official Contact | 9312105577 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Exac Care, Llc 229 Interstate Dr Suite 103 Crossville TN 38555-2709 Ph: (931) 210-5577 | Exac Care, Llc 229 Interstate Dr Suite 103 Crossville TN 38555-2709 Ph: (931) 210-5577 |
| NPI Number | 1518231679 |
|---|---|
| Provider Enumeration Date | 03/06/2012 |
| Last Update Date | 04/24/2018 |
| Medicare PECOS PAC ID | 7315100039 |
|---|---|
| Medicare Enrollment ID | O20120516000603 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518231679 | NPI | - | NPPES |
| 1529645 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Stacey B Carlton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619976941 PECOS PAC ID: 5395705552 Enrollment ID: I20050927001556 |
| Provider Name | April L Thornton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952744740 PECOS PAC ID: 0042457715 Enrollment ID: I20130516000595 |
| Provider Name | John M Lewis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336432798 PECOS PAC ID: 8729224431 Enrollment ID: I20140626000385 |
| Provider Name | Dustin Joe Moss |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023401619 PECOS PAC ID: 6103146162 Enrollment ID: I20150515000301 |
| Provider Name | Kimberly C Bell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356724108 PECOS PAC ID: 1951615913 Enrollment ID: I20150804005055 |
| Provider Name | Wendy Stout Henderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407232689 PECOS PAC ID: 1052615622 Enrollment ID: I20160203000142 |
| Provider Name | Wanda Jean Price |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306232418 PECOS PAC ID: 2466756457 Enrollment ID: I20160408001218 |
| Provider Name | Amandi N Proffitt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932568797 PECOS PAC ID: 3173822921 Enrollment ID: I20160428000757 |
| Provider Name | Adam J Hill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871024539 PECOS PAC ID: 6901175546 Enrollment ID: I20170713000171 |
| Provider Name | Amanda D Underwood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942724414 PECOS PAC ID: 5395010664 Enrollment ID: I20171012001698 |
| Provider Name | Christopher Delk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174011753 PECOS PAC ID: 0042557464 Enrollment ID: I20190123003088 |
| Provider Name | Julia V Ball |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336615871 PECOS PAC ID: 8628304888 Enrollment ID: I20190725000744 |
| Provider Name | Brandi M Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275158149 PECOS PAC ID: 0143643379 Enrollment ID: I20200707002054 |
| Provider Name | Heather S Dixon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225790645 PECOS PAC ID: 7214327568 Enrollment ID: I20211201001218 |
| Provider Name | Rebecca Michelle Fitzgerald |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700544541 PECOS PAC ID: 3678964616 Enrollment ID: I20211229001464 |
| Provider Name | Courtney Freels |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922860147 PECOS PAC ID: 7113360900 Enrollment ID: I20240208002476 |
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