MONTEREY MEDICAL LLC
NPI 1497339790
Clinic/Center - Rural Health in Monterey, TN
About Monterey Medical Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MONTEREY MEDICAL LLC (NPI 1497339790) is a healthcare organization registered as a rural health in Monterey, Tennessee and active in the NPI registry since May 2021. The organization holds a CLIA Waiver certificate valid through May 15, 2027 and lists Crystal Denise Vaughn, Vice President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
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)
Monterey Medical Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by February 28, 2027
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
12Medicare enrollment records show 12 clinicians reassign Medicare billing to Monterey Medical LLC, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.
Clinicians by Medicare Specialty 7
Clinicians, nearest first (12)
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 44D2224797
Monterey Medical, LLC · Monterey, 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 Monterey Medical LLC's NPI number?
The NPI number for Monterey Medical LLC is 1497339790. It was assigned to this organization in the NPPES registry on May 12, 2021.
Where is Monterey Medical LLC located?
Monterey Medical LLC is located at 400 W Crawford Ave, Monterey, TN 38574. The listed phone number is (931) 839-2224.
What is Monterey Medical LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.
Is Monterey Medical LLC enrolled in Medicare?
Yes. Monterey Medical LLC is registered in the Medicare PECOS enrollment system.
When is Monterey Medical LLC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Part A enrollment for this organization (Tennessee, Rural Health Clinic) is due for revalidation by February 28, 2027. 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 Monterey Medical LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 12 clinicians in 7 Medicare specialties reassign their Medicare billing to Monterey Medical LLC. 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. The largest specialties are Nurse Practitioner (6), Emergency Medicine (1) and Family Practice (1). Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Monterey Medical LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 44D2224797) is associated with this NPI, valid through May 15, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Monterey Medical LLC accept?
Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Monterey Medical LLC 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 Monterey Medical LLC was last updated on July 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.
# Monterey Medical Llc · NPI 1497339790
Rural Health organization in Monterey, Tennessee. Organization record, active in the CMS NPPES registry since May 12, 2021.
## Identity
- **NPI:** 1497339790 (Entity type: Organization)
- **Enumerated:** May 12, 2021
- **Primary specialty:** Clinic/Center - Rural Health · taxonomy 261QR1300X
- **Organization subpart:** No
- **Authorized official:** Crystal Vaughn, VICE PRESIDENT
## Practice location
- **Address:** 400 W CRAWFORD AVE, Monterey, TN 38574-1166
- **Phone:** (931) 839-2224 · **Fax:** (931) 839-2530
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** February 28, 2027 (Part A, Tennessee, Rural Health Clinic) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 12 clinicians in 7 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (6), Emergency Medicine (1), Family Practice (1); 2 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 8, 2021
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1497339790) · Data from the CMS NPPES public registry.