| Longevity Clinical Ltc Associates Of Tennessee, Pllc | |
|
309 Main St Red Boiling Springs TN 37150-2149 | |
| (615) 699-2238 | |
| Not Available |
| Full Name | Longevity Clinical Ltc Associates Of Tennessee, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 309 Main St, Red Boiling Springs, Tennessee |
| Authorized Official Name and Position | Diane Vincur (PRACTICE MANAGER) |
| Authorized Official Contact | 5618152427 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Longevity Clinical Ltc Associates Of Tennessee, Pllc 11780 Us Highway 1 Ste N107 North Palm Beach FL 33408-3007 Ph: (561) 815-2427 | Longevity Clinical Ltc Associates Of Tennessee, Pllc 309 Main St Red Boiling Springs TN 37150-2149 Ph: (615) 699-2238 |
| NPI Number | 1326878299 |
|---|---|
| Provider Enumeration Date | 08/06/2024 |
| Last Update Date | 08/06/2024 |
| Medicare PECOS PAC ID | 3779019146 |
|---|---|
| Medicare Enrollment ID | O20241209002269 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326878299 | NPI | - | NPPES |
| Provider Name | Sheila Yokley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558540666 PECOS PAC ID: 8628168036 Enrollment ID: I20071220000709 |
| Provider Name | Michelle Elizabeth Farrey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861053472 PECOS PAC ID: 0840527800 Enrollment ID: I20190813003812 |
| Provider Name | Kristina Michelle Rodgers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750052072 PECOS PAC ID: 5496144883 Enrollment ID: I20211104002215 |
| Provider Name | Sagar Dhanawade |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669992681 PECOS PAC ID: 1951673714 Enrollment ID: I20230928003646 |
| Provider Name | Jordan Ryan Kilgore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962185686 PECOS PAC ID: 9830609692 Enrollment ID: I20250610003290 |
3 Ple O Llpc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 165 Dale St, Red Boiling Springs, TN 37150 Phone: 615-699-3169 | |
Frank T Rutherford Memorial Hospital, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 718 Lafayette Rd, Red Boiling Springs, TN 37150 Phone: 615-699-4035 | |
Bray Family Health And Wellness, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 35 Spivey St, Red Boiling Springs, TN 37150 Phone: 615-699-7425 Fax: 615-699-7427 |