Grassy Fork Center is a medicare enrolled primary clinic (Clinic/center - Federally Qualified Health Center (fqhc)) in Hartford, Tennessee. The current practice location for Grassy Fork Center is 4261 Big Creek Rd, Hartford, Tennessee. For appointments, you can reach them via phone at
(423) 487-2249. The mailing address for Grassy Fork Center is 4261 Big Creek Rd, Hartford, Tennessee and phone number is (423) 487-2249.
Grassy Fork Center is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its
NPI number is 1871537639. This medical practice
accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at
(423) 487-2249.
Primary Care Clinic Profile
| Full Name | Grassy Fork Center |
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| Speciality | Clinic/Center |
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| Location | 4261 Big Creek Rd, Hartford, Tennessee |
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| Authorized Official Name and Position | Larry A Stanifer (CEO) |
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| Authorized Official Contact | 8655090055 |
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| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
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Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Grassy Fork Center
4261 Big Creek Rd
Hartford
TN 37753-2220
Ph: (423) 487-2249 | Grassy Fork Center
4261 Big Creek Rd
Hartford
TN 37753-2220
Ph: (423) 487-2249 |
NPI Details:
| NPI Number | 1871537639 |
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| Provider Enumeration Date | 06/15/2006 |
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| Last Update Date | 01/28/2008 |
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Medicare PECOS Information:
| Medicare PECOS PAC ID | 1456384080 |
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| Medicare Enrollment ID | O20071226000159 |
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Medical Identifiers
Medical identifiers for Grassy Fork Center such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1871537639 | NPI | - | NPPES |
| 0441858 | Medicaid | TN | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Grassy Fork Center acts as a billing entity for following providers:
| Provider Name | Ana Lucia Leon-arango |
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| Provider Type | Practitioner - Family Practice |
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| Provider Identifiers | NPI Number: 1013544634
PECOS PAC ID: 6800218454
Enrollment ID: I20230831001025 |
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