| Portland Primary Care Llc | |
|
103 Redbud Dr Suite E Portland TN 37148-1617 | |
| (615) 325-1206 | |
| (615) 325-1245 |
| Full Name | Portland Primary Care Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 103 Redbud Dr, Portland, Tennessee |
| Authorized Official Name and Position | Jeff Rydburg (VP) |
| Authorized Official Contact | 6153737415 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Portland Primary Care Llc 103 Redbud Dr Suite E Portland TN 37148-1617 Ph: (615) 325-1206 | Portland Primary Care Llc 103 Redbud Dr Suite E Portland TN 37148-1617 Ph: (615) 325-1206 |
| NPI Number | 1720034226 |
|---|---|
| Provider Enumeration Date | 05/26/2006 |
| Last Update Date | 12/11/2007 |
| Medicare PECOS PAC ID | 6305859851 |
|---|---|
| Medicare Enrollment ID | O20060728000322 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720034226 | NPI | - | NPPES |
| 3734188 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Guillermo Ludi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124097126 PECOS PAC ID: 2961415419 Enrollment ID: I20060728000313 |
| Provider Name | Alison D Kucich |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720029101 PECOS PAC ID: 5698776821 Enrollment ID: I20070130000658 |
| Provider Name | Helion W Cruz |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1871579409 PECOS PAC ID: 1456317015 Enrollment ID: I20090626000409 |
| Provider Name | Christopher Bachuss |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437147626 PECOS PAC ID: 4183611254 Enrollment ID: I20110113000298 |
| Provider Name | Enrique Cardenas Ramos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760821953 PECOS PAC ID: 1557649704 Enrollment ID: I20220110001086 |
Portland Prescription Shop Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 705 S Broadway St, Portland, TN 37148 Phone: 615-323-5050 Fax: 615-323-5052 | |
Michael D. Littell, D.o., Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 700 S Broadway, Portland, TN 37148 Phone: 615-325-3100 Fax: 615-325-0076 | |
Portland Primary Care, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 103 Redbud Dr, Suite E, Portland, TN 37148 Phone: 615-325-1206 | |
One To One Health Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 932 S Broadway St, Suite B, Portland, TN 37148 Phone: 423-718-9188 | |
Carehere Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: Carehere Clinic- Nasg Portland, Tn, 160 Kirby Drive, Portland, TN 37148 Phone: 615-221-5901 | |
Portland Family Wellness Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 700 S Broadway St, Portland, TN 37148 Phone: 615-325-3100 Fax: 615-325-0076 | |
Crossroads Medical Group, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 420 Highway 52 W, Portland, TN 37148 Phone: 615-672-7122 |