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AMEN CLINIC PC
NPI 1407121551
Family Medicine in Jackson, TN

Active since March 21, 2012CLIA 44D2038768 · Waiver
150 MURRAY GUARD DR, JACKSON, TN 38305(731) 300-3168(731) 300-3169 Get Directions Write a Review

NPPES record last updated: June 27, 2018. Verified against the NPPES registry weekly; last sync: September 06, 2026.

About Amen Clinic Pc NPPES

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

AMEN CLINIC PC (NPI 1407121551) is a healthcare organization registered as a family medicine in Jackson, Tennessee and active in the NPI registry since March 2012. The organization holds a CLIA Waiver certificate valid through March 25, 2028 and lists Ezekiel O Adetunji, Owner, as its authorized official.

NPPES Registry Identity

NPI1407121551
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameAMEN CLINIC PC
Location Address150 MURRAY GUARD DRJackson, TN 38305
Mailing AddressPo Box 12485Jackson, TN 38308-0143 · (731) 300-3168 · Fax (731) 300-3169
Phone(731) 300-3168
Fax(731) 300-3169
Organization SubpartNo
Authorized OfficialEzekiel O AdetunjiOwner · (731) 300-3168
Enumeration DateMarch 21, 2012
Last NPPES UpdateJune 27, 2018
✔ NPI 1407121551 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.
150 MURRAY GUARD DR, Jackson, TN 38305
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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 44D2038768

Amen Clinic · Jackson, TN
Active · expires Mar 25, 2028
CLIA Number44D2038768
Laboratory TypePhysician Office
Certificate Effective DateMarch 26, 2026
Certificate Expiration DateMarch 25, 2028
Laboratory DirectorEzekiel Adetunji
Laboratory Phone(731) 300-3168
Laboratory LocationAmen Clinic150 Murray Guard Drive, Jackson, TN 38305
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. EZEKIEL OLADEJO ADETUNJI MD
Family Medicine
150 MURRAY GUARD DR
JACKSON, TN 38305
Madison County (731) 300-3168
LAUREN SCHULTZ PA-C
Physician Assistant
150 MURRAY GUARD DR
JACKSON, TN 38305
Madison County (731) 201-2798

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 Amen Clinic PC's NPI number?

The NPI number for Amen Clinic PC is 1407121551. It was assigned to this organization in the NPPES registry on March 21, 2012.

Where is Amen Clinic PC located?

Amen Clinic PC is located at 150 Murray Guard Dr, Jackson, TN 38305. The listed phone number is (731) 300-3168.

What is Amen Clinic PC's specialty?

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

Does Amen Clinic PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 44D2038768) is associated with this NPI, valid through March 25, 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 Amen Clinic PC was last updated on June 27, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.