Waddell Clinic Primary Care & Aesthetics Pllc is a medicare enrolled primary clinic (Family Medicine) in Henry, Tennessee. The current practice location for Waddell Clinic Primary Care & Aesthetics Pllc is 9785 Hwy 79 S, Henry, Tennessee. For appointments, you can reach them via phone at
(731) 423-1450. The mailing address for Waddell Clinic Primary Care & Aesthetics Pllc is 940 Joy Sparks Rd, Mc Kenzie, Tennessee and phone number is (731) 415-8277.
Waddell Clinic Primary Care & Aesthetics Pllc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its
NPI number is 1851164560. This medical practice
accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at
(731) 423-1450.
Primary Care Clinic Profile
| Full Name | Waddell Clinic Primary Care & Aesthetics Pllc |
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| Speciality | Family Medicine |
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| Location | 9785 Hwy 79 S, Henry, Tennessee |
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| Authorized Official Name and Position | Donna Waddell (OWNER) |
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| Authorized Official Contact | 7314158277 |
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| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
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Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Waddell Clinic Primary Care & Aesthetics Pllc
940 Joy Sparks Rd
Mc Kenzie
TN 38201-5325
Ph: (731) 415-8277 | Waddell Clinic Primary Care & Aesthetics Pllc
9785 Hwy 79 S
Henry
TN 38231
Ph: (731) 423-1450 |
NPI Details:
| NPI Number | 1851164560 |
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| Provider Enumeration Date | 11/03/2023 |
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| Last Update Date | 03/13/2024 |
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Medicare PECOS Information:
| Medicare PECOS PAC ID | 2769835164 |
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| Medicare Enrollment ID | O20240201003092 |
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Medical Identifiers
Medical identifiers for Waddell Clinic Primary Care & Aesthetics Pllc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1851164560 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 363A00000X | Physician Assistant | (* (Not Available)) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Waddell Clinic Primary Care & Aesthetics Pllc acts as a billing entity for following providers:
| Provider Name | Donna P Waddell |
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| Provider Type | Practitioner - Nurse Practitioner |
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| Provider Identifiers | NPI Number: 1871733162
PECOS PAC ID: 6002973542
Enrollment ID: I20090326000656 |
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