EAST WOOD CLINIC PLLC
NPI 1073606778
Family Medicine in Paris, TN
About East Wood Clinic Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
EAST WOOD CLINIC PLLC (NPI 1073606778) is a healthcare organization registered as a family medicine in Paris, Tennessee and active in the NPI registry since October 2006. The organization holds a CLIA Waiver certificate valid through May 31, 2028 and lists Joshua David Roberts, Administrator, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 3
Other Identifiers 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
East Wood Clinic Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by December 31, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
6Medicare enrollment records show 6 clinicians reassign Medicare billing to East Wood Clinic PLLC, which bills Medicare for the services they deliver. Of these, 5 practice at this address. They are listed nearest first.
Clinicians, nearest first (6)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 44D1048585
East Wood Clinic PLLC · Paris, TNFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is East Wood Clinic PLLC's NPI number?
The NPI number for East Wood Clinic PLLC is 1073606778. It was assigned to this organization in the NPPES registry on October 2, 2006.
Where is East Wood Clinic PLLC located?
East Wood Clinic PLLC is located at 1323 East Wood Street, Paris, TN 38242. The listed phone number is (731) 642-2011.
What is East Wood Clinic PLLC's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is East Wood Clinic PLLC enrolled in Medicare?
Yes. East Wood Clinic PLLC is registered in the Medicare PECOS enrollment system.
When is East Wood Clinic PLLC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare DME enrollment for this organization (Tennessee, Physician - General Practice) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through East Wood Clinic PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians reassign their Medicare billing to East Wood Clinic PLLC, in Family Practice, Internal Medicine, Nurse Practitioner and Pediatric Medicine. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 5 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does East Wood Clinic PLLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 44D1048585) is associated with this NPI, valid through May 31, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does East Wood Clinic PLLC accept?
Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list East Wood Clinic PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for East Wood Clinic PLLC was last updated on October 8, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# East Wood Clinic Pllc · NPI 1073606778
Family Medicine organization in Paris, Tennessee. Organization record, active in the CMS NPPES registry since October 2, 2006.
## Identity
- **NPI:** 1073606778 (Entity type: Organization)
- **Enumerated:** October 2, 2006
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Joshua Roberts, ADMINISTRATOR
## Practice location
- **Address:** 1323 EAST WOOD STREET, Paris, TN 38242-4421
- **Phone:** (731) 642-2011 · **Fax:** (731) 644-2758
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** December 31, 2026 (DME, Tennessee, Physician - General Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 6 clinicians in 4 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Family Practice (2), Nurse Practitioner (2), Internal Medicine (1); 5 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 8, 2021
- **Other identifiers:** Medicaid 3731888 (TN)
- **CLIA laboratory certificates:** 1 on file
---
Source: [NPI Profile](https://npiprofile.com/npi/1073606778) · Data from the CMS NPPES public registry.