DEKALB MEDICAL CLINIC LLP
NPI 1700552890
Family Medicine in Smithville, TN
About Dekalb Medical Clinic Llp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DEKALB MEDICAL CLINIC LLP (NPI 1700552890) is a healthcare organization registered as a family medicine in Smithville, Tennessee and active in the NPI registry since August 2021. The organization holds a CLIA Waiver certificate valid through June 2, 2028 and lists Tonya R Jennings, Authorized Official, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
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)
Dekalb Medical Clinic Llp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by October 31, 2026
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
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Dekalb Medical Clinic LLP, 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 (2)
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 44D2261656
Dekalb Medical Clinic, LLP · Smithville, 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 Dekalb Medical Clinic LLP's NPI number?
The NPI number for Dekalb Medical Clinic LLP is 1700552890. It was assigned to this organization in the NPPES registry on August 18, 2021.
Where is Dekalb Medical Clinic LLP located?
Dekalb Medical Clinic LLP is located at 518 W Main St Ste C, Smithville, TN 37166. The listed phone number is (615) 597-4005.
What is Dekalb Medical Clinic LLP's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Dekalb Medical Clinic LLP enrolled in Medicare?
Yes. Dekalb Medical Clinic LLP is registered in the Medicare PECOS enrollment system.
When is Dekalb Medical Clinic LLP's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Tennessee, Clinic/Group Practice) is due for revalidation by October 31, 2026. 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 Dekalb Medical Clinic LLP?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Dekalb Medical Clinic LLP. 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.
Does Dekalb Medical Clinic LLP hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 44D2261656) is associated with this NPI, valid through June 2, 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 Dekalb Medical Clinic LLP was last updated on August 18, 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.
# Dekalb Medical Clinic Llp · NPI 1700552890
Family Medicine organization in Smithville, Tennessee. Organization record, active in the CMS NPPES registry since August 18, 2021.
## Identity
- **NPI:** 1700552890 (Entity type: Organization)
- **Enumerated:** August 18, 2021
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Tonya Jennings, AUTHORIZED OFFICIAL
## Practice location
- **Address:** 518 W MAIN ST STE C, Smithville, TN 37166-1100
- **Phone:** (615) 597-4005 · **Fax:** (615) 597-6667
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** October 31, 2026 (Non-DME Part B, Tennessee, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 2 clinicians (Nurse Practitioner) reassign Medicare billing to this organization (form CMS-855R); 1 practice at this address and 2 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 18, 2021
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1700552890) · Data from the CMS NPPES public registry.