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CHAMPION MEDICAL CARE LLC
NPI 1396606265
Family Medicine in Shelbyville, TN

Active since November 20, 2025CLIA 44D2337912 · Waiver
1114 N MAIN ST STE A, SHELBYVILLE, TN 37160(931) 652-9369 Get Directions Write a Review

NPPES record last updated: November 20, 2025. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Champion Medical Care Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHAMPION MEDICAL CARE LLC (NPI 1396606265) is a healthcare organization registered as a family medicine in Shelbyville, Tennessee and active in the NPI registry since November 2025. The organization holds a CLIA Waiver certificate valid through February 1, 2028 and lists John Mason Douglas, Np/owner, as its authorized official.

NPPES Registry Identity

NPI1396606265
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameCHAMPION MEDICAL CARE LLC
Location Address1114 N MAIN ST STE AShelbyville, TN 37160-2380
Mailing Address1114 N Main St Ste AShelbyville, TN 37160-2380
Phone(931) 652-9369
Organization SubpartNo
Authorized OfficialJohn Mason DouglasNp/owner · (931) 652-9369
Enumeration DateNovember 20, 2025
NPPES CertifiedNovember 20, 2025
✔ NPI 1396606265 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1114 N MAIN ST STE A, Shelbyville, TN 37160
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 44D2337912

Champion Medical Care LLC · Shelbyville, TN
Active · expires Feb 1, 2028
CLIA Number44D2337912
Laboratory TypePhysician Office
Certificate Effective DateFebruary 2, 2026
Certificate Expiration DateFebruary 1, 2028
Laboratory DirectorJohn M. Douglas
Laboratory Phone(931) 652-9369
Laboratory LocationChampion Medical Care LLC1114 North Main Street, Suite A, Shelbyville, TN 37160
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently 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 Champion Medical Care LLC's NPI number?

The NPI number for Champion Medical Care LLC is 1396606265. It was assigned to this organization in the NPPES registry on November 20, 2025.

Where is Champion Medical Care LLC located?

Champion Medical Care LLC is located at 1114 N Main St Ste A, Shelbyville, TN 37160. The listed phone number is (931) 652-9369.

What is Champion Medical Care LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Champion Medical Care LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 44D2337912) is associated with this NPI, valid through February 1, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Champion Medical Care LLC was last updated on November 20, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months 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.