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525 Royal Pkwy Nashville TN 37229-2878 | |
| (615) 579-2772 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 525 Royal Pkwy, Nashville, Tennessee |
| Authorized Official Name and Position | Kenneth Lamont Williams (PRESIDENT / CHIEF MEDICAL OFFICER) |
| Authorized Official Contact | 6155792772 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 292878 Nashville TN 37229-2878 Ph: (615) 579-2772 | 525 Royal Pkwy Nashville TN 37229-2878 Ph: (615) 579-2772 |
| NPI Number | 1700256971 |
|---|---|
| Provider Enumeration Date | 09/30/2015 |
| Last Update Date | 03/01/2021 |
| Medicare PECOS PAC ID | 1951610906 |
|---|---|
| Medicare Enrollment ID | O20151014002075 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700256971 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 46286 (Tennessee) | Primary |
| Provider Name | Kenneth L Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902062391 PECOS PAC ID: 8921288242 Enrollment ID: I20110203000577 |
| Provider Name | Ashley Caldwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427504588 PECOS PAC ID: 7810276888 Enrollment ID: I20161115000472 |
| Provider Name | Sheila Marie Douglas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760909261 PECOS PAC ID: 0749537702 Enrollment ID: I20180721000008 |
| Provider Name | Jamison Beth Cornett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093327066 PECOS PAC ID: 3870903867 Enrollment ID: I20201103000635 |
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