| Msmg Fp Im Mtn | |
|
1901 S Shady St Mountain City TN 37683-2021 | |
| (423) 727-1100 | |
| (423) 727-1105 |
| Full Name | Msmg Fp Im Mtn |
|---|---|
| Speciality | Family Medicine |
| Location | 1901 S Shady St, Mountain City, Tennessee |
| Authorized Official Name and Position | Dwayne Taylor (CEO) |
| Authorized Official Contact | 4235421333 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Msmg Fp Im Mtn 1901 S Shady St Mountain City TN 37683-2021 Ph: (423) 727-1100 | Msmg Fp Im Mtn 1901 S Shady St Mountain City TN 37683-2021 Ph: (423) 727-1100 |
| NPI Number | 1205846508 |
|---|---|
| Provider Enumeration Date | 08/09/2006 |
| Last Update Date | 10/27/2010 |
| Medicare PECOS PAC ID | 6002726718 |
|---|---|
| Medicare Enrollment ID | O20040415001070 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205846508 | NPI | - | NPPES |
| 3278673 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| Provider Name | Susanne M Shine |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659337772 PECOS PAC ID: 0345224549 Enrollment ID: I20040615001650 |
| Provider Name | James W Shine |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194781724 PECOS PAC ID: 2567446206 Enrollment ID: I20040617001588 |
| Provider Name | James M Shipley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912957937 PECOS PAC ID: 4486673019 Enrollment ID: I20051114000386 |
| Provider Name | Bernita J Armstrong |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1245218874 PECOS PAC ID: 7214936939 Enrollment ID: I20061206000582 |
| Provider Name | Ruth D Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316272453 PECOS PAC ID: 8325181720 Enrollment ID: I20100208000358 |
| Provider Name | Devapiran Jaishankar |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1225038490 PECOS PAC ID: 7618002080 Enrollment ID: I20100324000509 |
| Provider Name | Robert F Griffith |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235167990 PECOS PAC ID: 3678665684 Enrollment ID: I20110223001131 |
| Provider Name | Kanishka Chakraborty |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1992993760 PECOS PAC ID: 9335397447 Enrollment ID: I20120914000515 |
| Provider Name | Deborah Hassebrock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578819439 PECOS PAC ID: 5294984704 Enrollment ID: I20120926000842 |
| Provider Name | Megan D Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457644254 PECOS PAC ID: 0345462941 Enrollment ID: I20141115000312 |
| Provider Name | Jamie E Carnell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346632783 PECOS PAC ID: 2668792003 Enrollment ID: I20150526001882 |
| Provider Name | Emily Mcqueen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013390764 PECOS PAC ID: 2163723768 Enrollment ID: I20151228001169 |
| Provider Name | Lindsey Debord Yoggerst |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366962631 PECOS PAC ID: 7911270103 Enrollment ID: I20180907002853 |
| Provider Name | Michelle Lee Manuel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215431861 PECOS PAC ID: 1254681471 Enrollment ID: I20180910002797 |
| Provider Name | Sakshi Singal |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1356758239 PECOS PAC ID: 1355560863 Enrollment ID: I20191217002010 |
| Provider Name | Alina Bhat |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871907147 PECOS PAC ID: 2769737121 Enrollment ID: I20211025001927 |
| Provider Name | Suzan Page |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740716927 PECOS PAC ID: 5991074619 Enrollment ID: I20211208003089 |
| Provider Name | Danielle S Giles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750005492 PECOS PAC ID: 9739556440 Enrollment ID: I20221109003486 |
Msmg Ip Services Johnson County Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1901 S Shady St Ste A, Mountain City, TN 37683 Phone: 423-727-1103 Fax: 423-727-1140 | |
Mountain City Extended Hours Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1901 S Shady Street, Mountain City, TN 37683 Phone: 423-727-1150 Fax: 423-727-1152 | |
Donald F Tarr Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4200 Cold Springs Rd, Mountain City, TN 37683 Phone: 423-727-7743 Fax: 423-727-5509 | |
Donald R Walters Mdpc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 212 N Church St, Mountain City, TN 37683 Phone: 423-727-7711 Fax: 423-727-0209 | |
Bhrhc Mtncity Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1901 S Shady St, Mountain City, TN 37683 Phone: 423-727-1103 Fax: 423-727-1140 | |
Northeast Tennessee Health And Home Care Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 100 Kellogg Dr, Mountain City, TN 37683 Phone: 423-460-3232 Fax: 423-460-3234 |