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ULTIMATE HEALTH CLINIC PC
NPI 1669567707
Internal Medicine in Jackson, TN

Active since October 04, 2006
1673 N ROYAL ST, JACKSON, TN 38301(731) 265-1997(731) 265-0511 Get Directions Write a Review

NPPES record last updated: July 25, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Ultimate Health Clinic Pc NPPES

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

ULTIMATE HEALTH CLINIC PC (NPI 1669567707) is a healthcare organization registered as an internal medicine in Jackson, Tennessee and active in the NPI registry since October 2006. The organization lists Samuel Olaniyi Bada, Owner, as its authorized official.

NPPES Registry Identity

NPI1669567707
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameULTIMATE HEALTH CLINIC PC
Location Address1673 N ROYAL STJackson, TN 38301-3607
Mailing AddressPo Box 10156Jackson, TN 38308-0102 · (731) 265-1997 · Fax (731) 265-0511
Phone(731) 265-1997
Fax(731) 265-0511
Organization SubpartNo
Authorized OfficialSamuel Olaniyi BadaOwner · (731) 265-1997
Enumeration DateOctober 4, 2006
Last NPPES UpdateJuly 25, 2022
NPPES CertifiedJuly 25, 2022
✔ NPI 1669567707 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
1673 N ROYAL ST, Jackson, TN 38301
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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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ultimate Health Clinic Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Ultimate Health Clinic PC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

Samuel Bada, M.D.
Internal Medicine
NPI 1770530586
1673 N ROYAL ST
Jackson, TN 38301
(731) 265-1997
✔ PECOS✔ Accepts MedicareSame address
Gina Trombley
Nurse Practitioner
NPI 1518728724
6 MERRIMACK DR
Jackson, TN 38305
(815) 953-5880
✔ PECOS✔ Accepts Medicare7.3 mi
Shirley Collier, APRN
Nurse Practitioner
NPI 1780816413
557 W PARK PL
Henderson, TN 38340
(731) 989-1007
✔ PECOS16 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Ultimate Health Clinic PC's NPI number?

The NPI number for Ultimate Health Clinic PC is 1669567707. It was assigned to this organization in the NPPES registry on October 4, 2006.

Where is Ultimate Health Clinic PC located?

Ultimate Health Clinic PC is located at 1673 N Royal St, Jackson, TN 38301. The listed phone number is (731) 265-1997.

What is Ultimate Health Clinic PC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Ultimate Health Clinic PC enrolled in Medicare?

Yes. Ultimate Health Clinic PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Ultimate Health Clinic PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Ultimate Health Clinic PC, in Internal Medicine and Nurse Practitioner. 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. Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Ultimate Health Clinic PC was last updated on July 25, 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.