| Howard J Rupard Sole Mbr | |
|
529 W Commerce St Lewisburg TN 37091-3219 | |
| (931) 270-9729 | |
| (931) 270-9926 |
| Full Name | Howard J Rupard Sole Mbr |
|---|---|
| Speciality | Clinic/Center |
| Location | 529 W Commerce St, Lewisburg, Tennessee |
| Authorized Official Name and Position | Chad Graham (ADMINISTRATOR) |
| Authorized Official Contact | 9315800112 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Howard J Rupard Sole Mbr 529 W Commerce St Lewisburg TN 37091-3219 Ph: (931) 270-9729 | Howard J Rupard Sole Mbr 529 W Commerce St Lewisburg TN 37091-3219 Ph: (931) 270-9729 |
| NPI Number | 1891053823 |
|---|---|
| Provider Enumeration Date | 04/27/2012 |
| Last Update Date | 05/08/2015 |
| Medicare PECOS PAC ID | 4385883172 |
|---|---|
| Medicare Enrollment ID | O20130627000429 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891053823 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD024783 (Tennessee) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Joseph Howard Rupard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861451338 PECOS PAC ID: 7214052356 Enrollment ID: I20100914000285 |
| Provider Name | Melissa Monroe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043676422 PECOS PAC ID: 1254637721 Enrollment ID: I20160309000965 |
| Provider Name | Centeria Green Woolfolk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104343318 PECOS PAC ID: 6305112988 Enrollment ID: I20171026000790 |
| Provider Name | John Little |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649779786 PECOS PAC ID: 7214286079 Enrollment ID: I20180828001272 |
| Provider Name | Korevina Lasha Armstrong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184288938 PECOS PAC ID: 1951637065 Enrollment ID: I20190726002919 |
| Provider Name | Serena J Proudfoot |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497417232 PECOS PAC ID: 1254711310 Enrollment ID: I20220706003975 |
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