MEDINA FAMILY MEDICAL CLINIC PC
NPI 1609881150
Clinic/Center - Rural Health in Medina, TN
About Medina Family Medical Clinic Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MEDINA FAMILY MEDICAL CLINIC PC (NPI 1609881150) is a healthcare organization registered as a rural health in Medina, Tennessee and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through November 29, 2027 and lists Mechelle T Perry, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 3
Other Identifiers 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Medina Family Medical Clinic Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
8Medicare enrollment records show 8 clinicians reassign Medicare billing to Medina Family Medical Clinic PC, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 5 within 10 miles. They are listed nearest first.
Clinicians, nearest first (8)
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 44D1029832
Medina Family Medical Clinic, PC · Medina, 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 Medina Family Medical Clinic PC's NPI number?
The NPI number for Medina Family Medical Clinic PC is 1609881150. It was assigned to this organization in the NPPES registry on July 30, 2006.
Where is Medina Family Medical Clinic PC located?
Medina Family Medical Clinic PC is located at 209 Grace Cv, Medina, TN 38355. The listed phone number is (731) 783-0400.
What is Medina Family Medical Clinic PC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.
Is Medina Family Medical Clinic PC enrolled in Medicare?
Yes. Medina Family Medical Clinic PC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Medina Family Medical Clinic PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 8 clinicians in 2 Medicare specialties reassign their Medicare billing to Medina Family Medical Clinic PC. 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 (7) and Family Practice (1). Of these, 2 practice at this address and 5 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Medina Family Medical Clinic PC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 44D1029832) is associated with this NPI, valid through November 29, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Medina Family Medical Clinic PC accept?
Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Medina Family Medical Clinic PC 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 Medina Family Medical Clinic PC was last updated on October 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.
# Medina Family Medical Clinic Pc · NPI 1609881150
Rural Health organization in Medina, Tennessee. Organization record, active in the CMS NPPES registry since July 30, 2006.
## Identity
- **NPI:** 1609881150 (Entity type: Organization)
- **Enumerated:** July 30, 2006
- **Primary specialty:** Clinic/Center - Rural Health · taxonomy 261QR1300X
- **Organization subpart:** No
- **Authorized official:** Mechelle Perry, OWNER
## Practice location
- **Address:** 209 GRACE CV, Medina, TN 38355-8785
- **Phone:** (731) 783-0400 · **Fax:** (731) 783-0402
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 8 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (7), Family Practice (1); 2 practice at this address and 5 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 30, 2025
- **Other identifiers:** Medicaid 3727175 (TN)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1609881150) · Data from the CMS NPPES public registry.