| West Tennessee Medical Group Inc | |
|
620 Skyline Dr Jackson TN 38301-3923 | |
| (731) 660-8730 | |
| (731) 660-8739 |
| Full Name | West Tennessee Medical Group Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 620 Skyline Dr, Jackson, Tennessee |
| Authorized Official Name and Position | Bartley Teague (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7315121277 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| West Tennessee Medical Group Inc 1804 Highway 45 Byp Ste 604 Jackson TN 38305-4403 Ph: (731) 660-8730 | West Tennessee Medical Group Inc 620 Skyline Dr Jackson TN 38301-3923 Ph: (731) 660-8730 |
| NPI Number | 1053615955 |
|---|---|
| Provider Enumeration Date | 01/06/2011 |
| Last Update Date | 12/20/2018 |
| Medicare PECOS PAC ID | 3971781006 |
|---|---|
| Medicare Enrollment ID | O20110621000009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053615955 | NPI | - | NPPES |
| Provider Name | Felix Chukwudi Nnaji |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801890223 PECOS PAC ID: 5890781488 Enrollment ID: I20040421000128 |
| Provider Name | William R Carney |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770521940 PECOS PAC ID: 4688655525 Enrollment ID: I20040526001658 |
| Provider Name | Susan Kaye Godwin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831136787 PECOS PAC ID: 5799769808 Enrollment ID: I20040616000622 |
| Provider Name | Timothy E Ashmore |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154369320 PECOS PAC ID: 3971588559 Enrollment ID: I20040618001025 |
| Provider Name | Keith L Atkins |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417909086 PECOS PAC ID: 0840260782 Enrollment ID: I20040728001361 |
| Provider Name | Bethany J Lawrence |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1801823109 PECOS PAC ID: 2860471190 Enrollment ID: I20040814000048 |
| Provider Name | Walter F Fletcher |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043200280 PECOS PAC ID: 3870542293 Enrollment ID: I20050112000941 |
| Provider Name | James L Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912918491 PECOS PAC ID: 6800871880 Enrollment ID: I20050330001223 |
| Provider Name | Lattimore Madison Michael |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1164413928 PECOS PAC ID: 3476590894 Enrollment ID: I20050415000876 |
| Provider Name | Michael B Houchin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740269117 PECOS PAC ID: 6901845825 Enrollment ID: I20050429000765 |
| Provider Name | Daniel P Kayal |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1629025697 PECOS PAC ID: 5890736151 Enrollment ID: I20050517000439 |
| Provider Name | Kristi J Riddle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568452837 PECOS PAC ID: 8325080773 Enrollment ID: I20050525000757 |
| Provider Name | Kamran Mahalati |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1518934603 PECOS PAC ID: 2163464017 Enrollment ID: I20050601000674 |
| Provider Name | Kristi G Hazlewood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558350520 PECOS PAC ID: 6204856453 Enrollment ID: I20051201001029 |
| Provider Name | Ronald Mark Short |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1205823473 PECOS PAC ID: 7113932153 Enrollment ID: I20060213000794 |
| Provider Name | Joshua A Miller |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1790734242 PECOS PAC ID: 9436161106 Enrollment ID: I20060620000210 |
| Provider Name | Anne M Conquest |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1154358083 PECOS PAC ID: 3870506660 Enrollment ID: I20060721000024 |
| Provider Name | Amy W White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326016544 PECOS PAC ID: 8022014364 Enrollment ID: I20061010000714 |
| Provider Name | Kelly L Blair |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1891711131 PECOS PAC ID: 6507864923 Enrollment ID: I20061120000246 |
| Provider Name | Tommy L Miller |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1679506547 PECOS PAC ID: 9638108277 Enrollment ID: I20070125000596 |
| Provider Name | Misty Allen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801950225 PECOS PAC ID: 4082719554 Enrollment ID: I20070412000389 |
| Provider Name | Sumathira T Sathanandan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1760427496 PECOS PAC ID: 6800843590 Enrollment ID: I20070629000567 |
| Provider Name | Gloria A Burns |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932173259 PECOS PAC ID: 5294721247 Enrollment ID: I20070714000086 |
| Provider Name | Jason Weaver |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1972657252 PECOS PAC ID: 9234220146 Enrollment ID: I20070807000642 |
| Provider Name | Christopher Mitchell |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1932317880 PECOS PAC ID: 0042301418 Enrollment ID: I20070814000672 |
| Provider Name | Shawn A Baldwin |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1497829550 PECOS PAC ID: 1951493246 Enrollment ID: I20070816000146 |
| Provider Name | Kenna J Williams |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1770571853 PECOS PAC ID: 6800873035 Enrollment ID: I20071017000230 |
| Provider Name | Melissa A Appleton |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1144287053 PECOS PAC ID: 7719076199 Enrollment ID: I20071207000837 |
| Provider Name | Victor Go |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699954636 PECOS PAC ID: 8527143361 Enrollment ID: I20080304000693 |
| Provider Name | Michael W Brueggeman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1174628903 PECOS PAC ID: 5496825150 Enrollment ID: I20080606000405 |
| Provider Name | Donald A Wilson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1306815436 PECOS PAC ID: 4880767011 Enrollment ID: I20080722000403 |
| Provider Name | John J Ball |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1083609770 PECOS PAC ID: 4981777018 Enrollment ID: I20080722000506 |
| Provider Name | William F Pierce |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1326015462 PECOS PAC ID: 8325111297 Enrollment ID: I20080725000213 |
| Provider Name | Edward D Koonce |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1720067283 PECOS PAC ID: 8820165368 Enrollment ID: I20081021000301 |
| Provider Name | Thomas P Norsworthy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790764223 PECOS PAC ID: 8820165467 Enrollment ID: I20081021000533 |
| Provider Name | James D Day |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1235316886 PECOS PAC ID: 4486705159 Enrollment ID: I20090620000010 |
| Provider Name | Chibuzo Nwokolo |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1093921090 PECOS PAC ID: 4082714712 Enrollment ID: I20090715000712 |
| Provider Name | Monico Banez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962479451 PECOS PAC ID: 6406996008 Enrollment ID: I20091211000468 |
| Provider Name | James Edward Egan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1457346041 PECOS PAC ID: 8820131048 Enrollment ID: I20100210000061 |
| Provider Name | John W Baker |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1003801796 PECOS PAC ID: 5395744775 Enrollment ID: I20100210000109 |
| Provider Name | Steven Thorne |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1871561431 PECOS PAC ID: 7012051089 Enrollment ID: I20100216000024 |
| Provider Name | Fred G. Cox |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104830801 PECOS PAC ID: 2264493444 Enrollment ID: I20100609000316 |
| Provider Name | Enja O Holland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720317191 PECOS PAC ID: 0840321766 Enrollment ID: I20100621000890 |
| Provider Name | Paul Klimo |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1336127968 PECOS PAC ID: 0941246383 Enrollment ID: I20100706000331 |
| Provider Name | Stephanie L Einhaus |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1720078827 PECOS PAC ID: 3870482276 Enrollment ID: I20101011000745 |
| Provider Name | James D King |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144256157 PECOS PAC ID: 1355447061 Enrollment ID: I20101012000398 |
| Provider Name | Raul J Cardenas |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1619187697 PECOS PAC ID: 6507997848 Enrollment ID: I20101014000417 |
| Provider Name | Robert A Hollis |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1356393078 PECOS PAC ID: 5496841108 Enrollment ID: I20101019001043 |
| Provider Name | Alvin J Miller |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528270899 PECOS PAC ID: 3577553643 Enrollment ID: I20101025001103 |
| Provider Name | Eric M Sievers |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1629222427 PECOS PAC ID: 4284828948 Enrollment ID: I20101027000666 |
| Provider Name | Cindy K Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821024639 PECOS PAC ID: 3678767175 Enrollment ID: I20101028001016 |
| Provider Name | William Andrew Eason |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821025867 PECOS PAC ID: 3072619782 Enrollment ID: I20101029000507 |
| Provider Name | Brian Monroe Mccarver |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861428898 PECOS PAC ID: 6709982416 Enrollment ID: I20101029000814 |
| Provider Name | John William Vinson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063449007 PECOS PAC ID: 8527164235 Enrollment ID: I20101029000894 |
| Provider Name | Fielding A Randolph |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316180607 PECOS PAC ID: 0244428712 Enrollment ID: I20101228000371 |
| Provider Name | Dean Currie |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1356346142 PECOS PAC ID: 3971783036 Enrollment ID: I20110207000224 |
| Provider Name | David M Laird |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1376548503 PECOS PAC ID: 2567642622 Enrollment ID: I20110207000272 |
| Provider Name | David Villarreal |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1609871821 PECOS PAC ID: 2567642630 Enrollment ID: I20110207000398 |
| Provider Name | Tara N Hendrix |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467505958 PECOS PAC ID: 5395929905 Enrollment ID: I20110406000193 |
| Provider Name | Earnest L Murray |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1952597874 PECOS PAC ID: 1355471319 Enrollment ID: I20110819000353 |
| Provider Name | Tiffany B Gray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114201068 PECOS PAC ID: 0840463600 Enrollment ID: I20111024000515 |
| Provider Name | Anastasios L Georgious |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1972603785 PECOS PAC ID: 9234303405 Enrollment ID: I20111128000507 |
| Provider Name | Kenan Arnautovic |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1134118789 PECOS PAC ID: 8224127881 Enrollment ID: I20111201000752 |
| Provider Name | Natalie E Luttrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730465196 PECOS PAC ID: 9830364256 Enrollment ID: I20111214000426 |
| Provider Name | Andrew G Myers |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1548463631 PECOS PAC ID: 5193980753 Enrollment ID: I20120703000700 |
| Provider Name | Garrison B Smith |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1356561450 PECOS PAC ID: 4284890567 Enrollment ID: I20120801000330 |
| Provider Name | Nirav A Patel |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1790907418 PECOS PAC ID: 9436247731 Enrollment ID: I20120814000315 |
| Provider Name | Emily K Cooper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417212168 PECOS PAC ID: 1355597881 Enrollment ID: I20120815000590 |
| Provider Name | Sonia A Berry |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1699098335 PECOS PAC ID: 0547405706 Enrollment ID: I20130411000418 |
| Provider Name | John Keeley |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1316164288 PECOS PAC ID: 8527208719 Enrollment ID: I20130711000615 |
| Provider Name | Brittain D Little |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1053514141 PECOS PAC ID: 0042450975 Enrollment ID: I20130717000246 |
| Provider Name | Simon Okewole |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205000296 PECOS PAC ID: 5294898557 Enrollment ID: I20130924000431 |
| Provider Name | Tina R Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407195159 PECOS PAC ID: 9436386547 Enrollment ID: I20131217001736 |
| Provider Name | Naji Bourji |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1235318056 PECOS PAC ID: 5991969198 Enrollment ID: I20140807002052 |
| Provider Name | Adam Joseph Crouse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609287499 PECOS PAC ID: 8224255005 Enrollment ID: I20140819001675 |
| Provider Name | Stephanie D Anderson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891084935 PECOS PAC ID: 4587802079 Enrollment ID: I20140927000385 |
| Provider Name | Tesfaye Guyassa |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1366786352 PECOS PAC ID: 0042430498 Enrollment ID: I20141007000269 |
| Provider Name | James A Fisette |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184982969 PECOS PAC ID: 4486883584 Enrollment ID: I20150820011099 |
| Provider Name | William C Barrow |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1487970497 PECOS PAC ID: 9830409820 Enrollment ID: I20151103001903 |
| Provider Name | Grant Kneeland Studebaker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265774236 PECOS PAC ID: 0244479392 Enrollment ID: I20160831001947 |
| Provider Name | Amy Greer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497107874 PECOS PAC ID: 8628364809 Enrollment ID: I20160914002528 |
| Provider Name | Candice J Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629380639 PECOS PAC ID: 4082840533 Enrollment ID: I20160928002411 |
| Provider Name | Juan F Rodriguez Reyes |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1215147913 PECOS PAC ID: 7618093485 Enrollment ID: I20161018001948 |
| Provider Name | Brandy E Bartholomew |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063802346 PECOS PAC ID: 1254615446 Enrollment ID: I20170308000262 |
| Provider Name | Margaret Macgregor |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1679665541 PECOS PAC ID: 0244250751 Enrollment ID: I20170421001970 |
| Provider Name | Taylor B Mclean |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508259508 PECOS PAC ID: 2961793542 Enrollment ID: I20170607002381 |
| Provider Name | Melani Sidwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477091122 PECOS PAC ID: 8426321332 Enrollment ID: I20170828004763 |
| Provider Name | Traci Carol Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518490960 PECOS PAC ID: 8022381540 Enrollment ID: I20170906000159 |
| Provider Name | William W Scott |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1922178656 PECOS PAC ID: 3476771031 Enrollment ID: I20171003005788 |
| Provider Name | Andrius Lescauskas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316351844 PECOS PAC ID: 8224304472 Enrollment ID: I20171016003364 |
| Provider Name | Ashley L Hardee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407387509 PECOS PAC ID: 8729344676 Enrollment ID: I20171108002543 |
| Provider Name | Betsy Akin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720525991 PECOS PAC ID: 7810255064 Enrollment ID: I20171218002491 |
| Provider Name | Hetal D Patel |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1689991481 PECOS PAC ID: 2163666579 Enrollment ID: I20180126000472 |
| Provider Name | Theodore S Wright |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1699758268 PECOS PAC ID: 9436102555 Enrollment ID: I20180427001017 |
| Provider Name | Khawaja M Muddassir |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1003043043 PECOS PAC ID: 7214082072 Enrollment ID: I20180817002452 |
| Provider Name | Brian Md Fullwood |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487048880 PECOS PAC ID: 0143533729 Enrollment ID: I20180821001633 |
| Provider Name | Matthew A Ramsey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699261099 PECOS PAC ID: 8729339155 Enrollment ID: I20180925002178 |
| Provider Name | Jeffrey Hal Gillis |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1508125626 PECOS PAC ID: 8921248527 Enrollment ID: I20181008001352 |
| Provider Name | Tonya Burton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588158455 PECOS PAC ID: 7517219611 Enrollment ID: I20181017001432 |
| Provider Name | Scott S Norris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669954889 PECOS PAC ID: 4486907391 Enrollment ID: I20181023001651 |
| Provider Name | Ashleigh E Mcintosh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801247945 PECOS PAC ID: 2961790076 Enrollment ID: I20181027000152 |
| Provider Name | Jennifer Rice |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700360211 PECOS PAC ID: 0547505943 Enrollment ID: I20181212002491 |
| Provider Name | Justin R Turner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235670647 PECOS PAC ID: 2365712627 Enrollment ID: I20181220002834 |
| Provider Name | Kelley P Lumley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679047146 PECOS PAC ID: 5890034730 Enrollment ID: I20190311002648 |
| Provider Name | Sarah S Bateman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295298255 PECOS PAC ID: 1456684547 Enrollment ID: I20190604002642 |
| Provider Name | Leslie Carroll |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255994166 PECOS PAC ID: 9436485448 Enrollment ID: I20190730000842 |
| Provider Name | Kristen N Massey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811454424 PECOS PAC ID: 6709119035 Enrollment ID: I20190730003733 |
| Provider Name | Walter John Jermakowicz |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1922369750 PECOS PAC ID: 4587997119 Enrollment ID: I20190731002458 |
| Provider Name | Kyle A Smith |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1194081232 PECOS PAC ID: 2466770912 Enrollment ID: I20190731003055 |
| Provider Name | Nicholas L Treece |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679923759 PECOS PAC ID: 7214220854 Enrollment ID: I20190827001704 |
| Provider Name | Aaron Michael Lewis |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1689933491 PECOS PAC ID: 5395036958 Enrollment ID: I20190917002542 |
| Provider Name | Ankur Ahuja |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1912263005 PECOS PAC ID: 8527369990 Enrollment ID: I20191001002591 |
| Provider Name | Kirsten Siler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013559186 PECOS PAC ID: 4183058746 Enrollment ID: I20200107002727 |
| Provider Name | Janna Haskins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881238533 PECOS PAC ID: 5799111282 Enrollment ID: I20200131000535 |
| Provider Name | Hannah Keel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851934723 PECOS PAC ID: 2860829546 Enrollment ID: I20200218001862 |
| Provider Name | Jonathan D Braun |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1689961716 PECOS PAC ID: 2668809294 Enrollment ID: I20200220002201 |
| Provider Name | Robert G Day |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235120437 PECOS PAC ID: 0840231148 Enrollment ID: I20200310002593 |
| Provider Name | Tina F Woodson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891233342 PECOS PAC ID: 3173868536 Enrollment ID: I20200326003329 |
| Provider Name | Bonna Gollihugh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558901280 PECOS PAC ID: 9739519869 Enrollment ID: I20200413003856 |
| Provider Name | Veronica T. Jarido |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073871133 PECOS PAC ID: 0244546794 Enrollment ID: I20200728000142 |
| Provider Name | Rachael L Armstrong |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1366735300 PECOS PAC ID: 4587892161 Enrollment ID: I20200728002111 |
| Provider Name | Jordi Puente Espel |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1851657597 PECOS PAC ID: 9032496716 Enrollment ID: I20200730003667 |
| Provider Name | Bryant Unruh |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1245650746 PECOS PAC ID: 0840615365 Enrollment ID: I20200730003791 |
| Provider Name | Derek I Thacker |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1538570544 PECOS PAC ID: 3678899069 Enrollment ID: I20200908000015 |
| Provider Name | Seth Patrick Hayes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316441983 PECOS PAC ID: 7214287986 Enrollment ID: I20200923000819 |
| Provider Name | Randall A Wright |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1902903438 PECOS PAC ID: 1759410442 Enrollment ID: I20201112003168 |
| Provider Name | Trenis L Nash |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598305336 PECOS PAC ID: 5193135226 Enrollment ID: I20210105000057 |
| Provider Name | Adrean R Stamper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194321893 PECOS PAC ID: 7517374879 Enrollment ID: I20210402000345 |
| Provider Name | Adam D Reinhard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346831138 PECOS PAC ID: 0547678450 Enrollment ID: I20210414000584 |
| Provider Name | Douglas R Taylor |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1578983797 PECOS PAC ID: 3577972256 Enrollment ID: I20210510001524 |
| Provider Name | Tara Marie Roberts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477092864 PECOS PAC ID: 1759790009 Enrollment ID: I20210517002492 |
| Provider Name | Daniel W Branch |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1790105245 PECOS PAC ID: 8921387135 Enrollment ID: I20210707000714 |
| Provider Name | Joshua D Downey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255893699 PECOS PAC ID: 7719213990 Enrollment ID: I20210716001557 |
| Provider Name | Rachel A Robinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316531676 PECOS PAC ID: 8426451725 Enrollment ID: I20210723002637 |
| Provider Name | Nestor A Arita |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1124438072 PECOS PAC ID: 4385987619 Enrollment ID: I20210726003338 |
| Provider Name | Jonathan Michael Davis |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1053738336 PECOS PAC ID: 8022239839 Enrollment ID: I20210810001807 |
| Provider Name | Haley Daigle |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1942658596 PECOS PAC ID: 8921396144 Enrollment ID: I20210824000690 |
| Provider Name | Michael R Todd |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1366404600 PECOS PAC ID: 9234149204 Enrollment ID: I20210922003450 |
| Provider Name | Amanda E Russell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932879392 PECOS PAC ID: 6507257458 Enrollment ID: I20220103001539 |
| Provider Name | Clara T Barrow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154083657 PECOS PAC ID: 6406247121 Enrollment ID: I20220106001164 |
| Provider Name | Rachel Tosh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124772587 PECOS PAC ID: 0547653578 Enrollment ID: I20220215000837 |
| Provider Name | Victoria S Watson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396373510 PECOS PAC ID: 6901220268 Enrollment ID: I20220406001064 |
| Provider Name | Shannon E Burke |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1245686401 PECOS PAC ID: 5597053702 Enrollment ID: I20220616001903 |
| Provider Name | Natasha Y Austin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881331387 PECOS PAC ID: 5597144535 Enrollment ID: I20220621002994 |
| Provider Name | Cameron S Michael |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1205323433 PECOS PAC ID: 2567842545 Enrollment ID: I20220707004146 |
| Provider Name | Sahai V Donaldson |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1548716335 PECOS PAC ID: 5991186405 Enrollment ID: I20220714003237 |
| Provider Name | Crystal M Legions-holden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184353096 PECOS PAC ID: 6507247517 Enrollment ID: I20220722000690 |
| Provider Name | Maunil Nikhil Bhatt |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1710321989 PECOS PAC ID: 7719119692 Enrollment ID: I20220910000710 |
| Provider Name | Morgan L Fields |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376273730 PECOS PAC ID: 5395120323 Enrollment ID: I20220912002878 |
| Provider Name | William P Thomas |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1184646234 PECOS PAC ID: 9638192487 Enrollment ID: I20221110001969 |
| Provider Name | Samantha Lochridge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093306342 PECOS PAC ID: 1052780848 Enrollment ID: I20221219000825 |
| Provider Name | Scott Summars |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750872420 PECOS PAC ID: 4183097991 Enrollment ID: I20230227000344 |
| Provider Name | Micah Whitnell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336845734 PECOS PAC ID: 0648636332 Enrollment ID: I20230523001448 |
| Provider Name | Stephanie Kekulawela |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1396979175 PECOS PAC ID: 1355645755 Enrollment ID: I20230628002951 |
| Provider Name | Danny J Montenegro |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780209049 PECOS PAC ID: 8123442837 Enrollment ID: I20230803000663 |
| Provider Name | Malik D Murtaza |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1437605151 PECOS PAC ID: 1850781329 Enrollment ID: I20230807002962 |
| Provider Name | Muhammad Ahsan |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1063967057 PECOS PAC ID: 0840686150 Enrollment ID: I20230829000777 |
| Provider Name | Martin Woon |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1902156755 PECOS PAC ID: 4183873904 Enrollment ID: I20231013001728 |
| Provider Name | Katelyn B Watkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326747940 PECOS PAC ID: 2062861883 Enrollment ID: I20231205003320 |
| Provider Name | Kelley N Fowler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730961178 PECOS PAC ID: 9537518832 Enrollment ID: I20231212002935 |
| Provider Name | Emily D Garner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740056167 PECOS PAC ID: 9234575168 Enrollment ID: I20240313002626 |
Therapy & Learning Center Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 32 Garland Dr, Jackson, TN 38305 Phone: 731-668-3322 Fax: 731-664-2491 | |
Wellness Clinic And Family Care Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 21 Meridian Springs Dr, Jackson, TN 38301 Phone: 731-256-0526 Fax: 731-256-1720 | |
Ultimate Health Clinic North Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 16 Murray Guard Dr Ste B, Jackson, TN 38305 Phone: 731-660-0887 Fax: 731-660-9996 | |
West Tennessee Medical Group Ut Medicine Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 294 Summar Dr, Jackson, TN 38301 Phone: 731-423-1932 Fax: 731-660-8739 | |
The Medical Clinic Of Jackson Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 587 Skyline Dr, Jackson, TN 38301 Phone: 731-424-8922 Fax: 731-423-2922 | |
Northside Medical Clinic, P.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 31 Hughes Dr, Jackson, TN 38305 Phone: 731-668-2800 Fax: 731-668-6161 |