| Northcrest Physician Services Inc | |
|
417 Northcrest Dr 430 Northcrest Dr Springfield TN 37172-3973 | |
| (615) 382-5710 | |
| (615) 382-5776 |
| Full Name | Northcrest Physician Services Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 417 Northcrest Dr, Springfield, Tennessee |
| Authorized Official Name and Position | Jerlyn S Davis (BILLER) |
| Authorized Official Contact | 6153825710 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northcrest Physician Services Inc Po Box 969 Springfield TN 37172-0969 Ph: (615) 382-5710 | Northcrest Physician Services Inc 417 Northcrest Dr 430 Northcrest Dr Springfield TN 37172-3973 Ph: (615) 382-5710 |
| NPI Number | 1356561856 |
|---|---|
| Provider Enumeration Date | 04/26/2007 |
| Last Update Date | 10/28/2008 |
| Medicare PECOS PAC ID | 5092619197 |
|---|---|
| Medicare Enrollment ID | O20040119000711 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356561856 | NPI | - | NPPES |
| 3709970 | Other | TN | MEDICARE GROUP NUMBER |
| 3371051 | Other | TN | MEDICARE GROUP NUMBER |
| 3709979 | Other | TN | MEDICARE GROUP NUMBER |
| Provider Name | Kirk A. Nienaber |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932172103 PECOS PAC ID: 3678466158 Enrollment ID: I20040206000850 |
| Provider Name | John Mark Pennington |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063506921 PECOS PAC ID: 6800853060 Enrollment ID: I20041220000459 |
| Provider Name | Christine A Demers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669582078 PECOS PAC ID: 2163475864 Enrollment ID: I20050222000826 |
| Provider Name | Gail C Wakefield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710072335 PECOS PAC ID: 1658327341 Enrollment ID: I20050325000028 |
| Provider Name | Gilbert Bazaldua |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417011008 PECOS PAC ID: 2264512813 Enrollment ID: I20080108000708 |
| Provider Name | Robert Guy Ferland |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447256490 PECOS PAC ID: 5597847491 Enrollment ID: I20080131000164 |
| Provider Name | Christopher F Standley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972652352 PECOS PAC ID: 2264511948 Enrollment ID: I20080506000731 |
| Provider Name | Donna Allison Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710984182 PECOS PAC ID: 0941363204 Enrollment ID: I20090113000253 |
| Provider Name | William E Burt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154542926 PECOS PAC ID: 4880753904 Enrollment ID: I20090113000489 |
| Provider Name | John Westerkamm |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1104812478 PECOS PAC ID: 6507805223 Enrollment ID: I20090325000429 |
| Provider Name | Dennis L Rainwater |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316974678 PECOS PAC ID: 1456386366 Enrollment ID: I20090717000263 |
| Provider Name | William M Lewis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316944648 PECOS PAC ID: 1355439613 Enrollment ID: I20100218000086 |
| Provider Name | Donna Regina Shell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982724076 PECOS PAC ID: 8921293960 Enrollment ID: I20101116000449 |
| Provider Name | George Anthony Dahir |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1215922711 PECOS PAC ID: 4385823814 Enrollment ID: I20110128000892 |
| Provider Name | Anne E Eyler |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1659428548 PECOS PAC ID: 9739359068 Enrollment ID: I20110824000548 |
| Provider Name | Ronnie Lee Jackson |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1174500896 PECOS PAC ID: 9537336375 Enrollment ID: I20120119000759 |
| Provider Name | Jill E Cutright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689980047 PECOS PAC ID: 1557523750 Enrollment ID: I20120504000414 |
| Provider Name | April A Reyes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639334097 PECOS PAC ID: 7214190560 Enrollment ID: I20120523000602 |
| Provider Name | Patricia Marie Powers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396012399 PECOS PAC ID: 1557525359 Enrollment ID: I20120606000750 |
| Provider Name | Syeda S Zaidi |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1407057946 PECOS PAC ID: 5890942205 Enrollment ID: I20120820000833 |
| Provider Name | Tamara Faith Batson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740352970 PECOS PAC ID: 5991959488 Enrollment ID: I20130211000109 |
| Provider Name | Matthew T Garner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306092960 PECOS PAC ID: 4183892623 Enrollment ID: I20140415002010 |
| Provider Name | Annola K Dildy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376747931 PECOS PAC ID: 7214107507 Enrollment ID: I20140606001238 |
| Provider Name | Miranda Kay Barrow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053701052 PECOS PAC ID: 5597076539 Enrollment ID: I20150617003111 |
| Provider Name | Ashley D Gussoni |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992255764 PECOS PAC ID: 8224318456 Enrollment ID: I20161206000561 |
| Provider Name | Aiyappan Menon |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1447341755 PECOS PAC ID: 6709783871 Enrollment ID: I20180626003522 |
| Provider Name | Shannon M Depriest |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598212854 PECOS PAC ID: 7618228347 Enrollment ID: I20180919003161 |
| Provider Name | Gabrielle Elise Saucedo Cook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710404413 PECOS PAC ID: 9638421779 Enrollment ID: I20181017003027 |
| Provider Name | Charles Andrew Mullins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881628998 PECOS PAC ID: 0648210633 Enrollment ID: I20190306003688 |
| Provider Name | Angela Marie Wiggins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215490024 PECOS PAC ID: 9638501513 Enrollment ID: I20191114001073 |
| Provider Name | Jon Sands Tyrell |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1033129945 PECOS PAC ID: 2264565449 Enrollment ID: I20200325000881 |
Donald J. Boatright Md., Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 205 5th Ave E, Springfield, TN 37172 Phone: 615-384-7580 Fax: 615-384-0516 | |
Teresa Marie Williams, M.d. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 221 Northcrest Dr, Springfield, TN 37172 Phone: 615-384-4050 Fax: 615-384-7493 | |
Urgent Team Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2006 Memorial Blvd Ste 101, Springfield, TN 37172 Phone: 615-380-8411 Fax: 615-380-8420 | |
Forest Park Ventures Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3438 Forest Park Rd, Springfield, TN 37172 Phone: 615-708-7546 | |
Medical Necessities Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 205 5th Ave E, Springfield, TN 37172 Phone: 615-384-0569 | |
Millbrook Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 801 Hill St, Springfield, TN 37172 Phone: 615-384-5554 Fax: 615-384-5534 |