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PRIMARY CARE CLINIC OF JACKSON
NPI 1609309855
Clinic/Center in Jackson, TN

Active since April 05, 2017
54 EXETER RD STE B, JACKSON, TN 38305(731) 935-9463 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 21, 2022, Jan 27, 2020, Dec 12, 2019 and 1 more (4 updates tracked since 2017).

About Primary Care Clinic Of Jackson NPPES

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

PRIMARY CARE CLINIC OF JACKSON (NPI 1609309855) is a healthcare organization registered as a clinic/center in Jackson, Tennessee and active in the NPI registry since April 2017. The organization maintains a secondary practice location in Jackson and lists Kathy Michelle O'connor-wray, Fnp, Owner, as its authorized official.

NPPES Registry Identity

NPI1609309855
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NamePRIMARY CARE CLINIC OF JACKSON
Location Address54 EXETER RD STE BJackson, TN 38305-1985
Mailing Address8 Stonebridge Blvd Ste MJackson, TN 38305-2178 · (731) 265-6197 · Fax (731) 265-6198
Phone(731) 935-9463
Organization SubpartNo
Authorized OfficialKathy Michelle O'connor-wrayFnp, Owner · (731) 265-6197
Enumeration DateApril 5, 2017
Last NPPES UpdateJuly 21, 20224 updates tracked since enumeration
NPPES CertifiedJuly 21, 2022
✔ NPI 1609309855 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
License✔ Licensed in TN · 000896897
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
54 EXETER RD STE B, Jackson, TN 38305
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Secondary Practice Location 1

Location 18 Stonebridge Blvd Ste MJackson, TN 38305-2178 · Phone (731) 265-6197 · Fax (731) 265-6198

Other Providers at the Same Location NPPES 3

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

MS. REBECCA BURROW APRN, FNP-C
Nurse Practitioner (Family)
54 EXETER RD STE B
JACKSON, TN 38305
Madison County (731) 265-6197
AUBREY ROGERS
Nurse Practitioner (Primary Care)
54 EXETER RD STE B
JACKSON, TN 38305
Madison County (731) 540-0220
SARA E WARD FNP-C
Nurse Practitioner (Family)
54 EXETER RD STE B
JACKSON, TN 38305
Madison County (731) 265-6197

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 Primary Care Clinic Of Jackson's NPI number?

The NPI number for Primary Care Clinic Of Jackson is 1609309855. It was assigned to this organization in the NPPES registry on April 5, 2017.

Where is Primary Care Clinic Of Jackson located?

Primary Care Clinic Of Jackson is located at 54 Exeter Rd Ste B, Jackson, TN 38305. The listed phone number is (731) 935-9463.

What is Primary Care Clinic Of Jackson's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

When was this NPI record last updated?

The NPPES record for Primary Care Clinic Of Jackson was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.