| Mckenzie Medical Center Pc | |
|
205a Hospital Dr Mc Kenzie TN 38201-1649 | |
| (731) 352-7907 | |
| (833) 690-3848 |
| Full Name | Mckenzie Medical Center Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 205a Hospital Dr, Mc Kenzie, Tennessee |
| Authorized Official Name and Position | Tammy Etheridge (CHIEF OPERATING OFFICER) |
| Authorized Official Contact | 7313527907 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mckenzie Medical Center Pc 205a Hospital Dr Mc Kenzie TN 38201-1649 Ph: (731) 352-7907 | Mckenzie Medical Center Pc 205a Hospital Dr Mc Kenzie TN 38201-1649 Ph: (731) 352-7907 |
| NPI Number | 1700534229 |
|---|---|
| Provider Enumeration Date | 03/14/2022 |
| Last Update Date | 03/31/2025 |
| Medicare PECOS PAC ID | 2365427853 |
|---|---|
| Medicare Enrollment ID | O20040619000083 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700534229 | NPI | - | NPPES |
| Provider Name | Terry Andrew Colotta |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659374296 PECOS PAC ID: 8729063060 Enrollment ID: I20040622000185 |
| Provider Name | Joseph R Hames |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1699721092 PECOS PAC ID: 4082663463 Enrollment ID: I20050113000243 |
| Provider Name | Bryan Hale Merrick |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467455287 PECOS PAC ID: 7416921895 Enrollment ID: I20050720000089 |
| Provider Name | Judy B Bain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811133622 PECOS PAC ID: 1658429535 Enrollment ID: I20090622000066 |
| Provider Name | Edwin G Anderson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1609833227 PECOS PAC ID: 8123169547 Enrollment ID: I20100213000043 |
| Provider Name | Scott Louis Spivey |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1861481095 PECOS PAC ID: 7416072244 Enrollment ID: I20100916000287 |
| Provider Name | Leslie Leeann Ellis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790063212 PECOS PAC ID: 0547430621 Enrollment ID: I20110829000031 |
| Provider Name | Tanya L Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205132206 PECOS PAC ID: 8123287810 Enrollment ID: I20120315000855 |
| Provider Name | Jonathan Edgar Searcy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710291828 PECOS PAC ID: 9638331440 Enrollment ID: I20120424000125 |
| Provider Name | Kenneth Scott Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811237001 PECOS PAC ID: 2163663931 Enrollment ID: I20130722000341 |
| Provider Name | Jami Ivey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083797211 PECOS PAC ID: 8325357650 Enrollment ID: I20151027001901 |
| Provider Name | Lynn Nicole Redmond |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871942201 PECOS PAC ID: 2163714015 Enrollment ID: I20160713001111 |
| Provider Name | Erin Legens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326430620 PECOS PAC ID: 6507147857 Enrollment ID: I20161229000780 |
| Provider Name | Mark Vinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699255794 PECOS PAC ID: 6507119245 Enrollment ID: I20181027000029 |
| Provider Name | Jacqueline Hicks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245735943 PECOS PAC ID: 4486995388 Enrollment ID: I20190402002034 |
| Provider Name | Dawn Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912468505 PECOS PAC ID: 8729320692 Enrollment ID: I20190424001322 |
| Provider Name | Trent Jim-e Theriac |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134686116 PECOS PAC ID: 0840533311 Enrollment ID: I20190524000631 |
| Provider Name | Mary Rebecca Wall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134689920 PECOS PAC ID: 0840523270 Enrollment ID: I20190617003117 |
| Provider Name | Matthew W Roberts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932763059 PECOS PAC ID: 9032449103 Enrollment ID: I20191002003996 |
| Provider Name | Hollie Frazier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013544576 PECOS PAC ID: 3678902442 Enrollment ID: I20200330001575 |
| Provider Name | Alison Knack |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700423365 PECOS PAC ID: 9234551532 Enrollment ID: I20200615001384 |
| Provider Name | Angelia Dotson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245825249 PECOS PAC ID: 8123434743 Enrollment ID: I20210305001797 |
| Provider Name | Kristin Russell Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508182726 PECOS PAC ID: 4486824406 Enrollment ID: I20210629001362 |
| Provider Name | Bobbie J Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659945418 PECOS PAC ID: 4880091404 Enrollment ID: I20210924001073 |
| Provider Name | Tywanda Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194960302 PECOS PAC ID: 8325221674 Enrollment ID: I20211115001038 |
| Provider Name | Patricia Cunningham |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225422355 PECOS PAC ID: 2668851817 Enrollment ID: I20220620000783 |
| Provider Name | Briana Page Chandler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790408466 PECOS PAC ID: 5597141846 Enrollment ID: I20221011000025 |
| Provider Name | Victoria Brooke Ivy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235918947 PECOS PAC ID: 0244685741 Enrollment ID: I20231018000268 |
| Provider Name | Megan Elise Ethredge |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669128237 PECOS PAC ID: 4284076670 Enrollment ID: I20240530003709 |
| Provider Name | Rachelle Hale |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225869225 PECOS PAC ID: 0042744898 Enrollment ID: I20241115001458 |
Mckenzie Medical Center Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1894 Cedar St, Mc Kenzie, TN 38201 Phone: 731-352-7907 Fax: 833-690-3848 | |
Mckenzie Clinic Corp Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 Hospital Dr, Mc Kenzie, TN 38201 Phone: 615-465-7645 Fax: 615-465-3017 | |
Bethel Universtiy Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 325 Cherry Ave # 335, Mc Kenzie, TN 38201 Phone: 731-352-4000 Fax: 731-352-4238 | |
Mckenzie Medical Center Lab Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 205 Hospital Dr, Suite A, Mc Kenzie, TN 38201 Phone: 731-352-7907 Fax: 731-352-4459 | |
Bethel Universtiy Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 325 Cherry Ave, Mc Kenzie, TN 38201 Phone: 972-367-4845 | |
Mckenzie Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 205 Hospital Dr, Suite A, Mc Kenzie, TN 38201 Phone: 731-352-7907 Fax: 731-352-4459 |