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SUMMIT CONVENIENT CARE AT LEBANON LLC NPI 1568627271


NPI Information

NPI: 1568627271
Provider Name: SUMMIT CONVENIENT CARE AT LEBANON LLC
Classification: Nurse Practitioner - 363L00000X
Entity Type: Organization
Address:
100 PHYSICIANS WAY
SUITE 110
LEBANON, TN
ZIP 37090
Phone: (615) 449-1100
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SUMMIT CONVENIENT CARE AT LEBANON LLC is a nurse practitioner in Lebanon, TN. The provider is (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. SUMMIT CONVENIENT CARE AT LEBANON LLC NPI is 1568627271. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

100 PHYSICIANS WAY
SUITE 110
LEBANON, TN
ZIP 37090-102
Phone: (615) 449-1100
Fax: (615) 449-1150

The provider's authorized official is Gary Duncan .
The authorized official title is Vice President and has the following contact phone number (615) 372-5135.

The enumeration date for this NPI number is 7/22/2008 and was last updated on 5/20/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363L00000XNurse PractitionerYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11511412MEDICAIDTENNESSEE
24214465OTHERTENNESSEEBCBS
33002280MEDICARE PINTENNESSEE
4DO3658OTHERTENNESSEERR MEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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