Provider Demographics
NPI:1215322425
Name:BARTON FAMILY HEALTH CLINIC, LLC
Entity type:Organization
Organization Name:BARTON FAMILY HEALTH CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:YVETTE
Authorized Official - Middle Name:COOPER
Authorized Official - Last Name:BARTON
Authorized Official - Suffix:
Authorized Official - Credentials:APN, FNP
Authorized Official - Phone:731-407-9300
Mailing Address - Street 1:2835 E WOOD ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:PARIS
Mailing Address - State:TN
Mailing Address - Zip Code:38242-5948
Mailing Address - Country:US
Mailing Address - Phone:731-407-9300
Mailing Address - Fax:731-407-9301
Practice Address - Street 1:2835 E WOOD ST
Practice Address - Street 2:SUITE E
Practice Address - City:PARIS
Practice Address - State:TN
Practice Address - Zip Code:38242-5948
Practice Address - Country:US
Practice Address - Phone:731-407-9300
Practice Address - Fax:731-407-9301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-03
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN15828261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN03230949OtherAMERIGROUP PROVIDER #
TNINDIVIDUAL # Q006027Medicaid
TN6042199OtherBCBS PROVIDER #
TN1194018622OtherINDIVIDUAL NPI
TN1215322425OtherGROUP NPI
TNGROUP # Q013971Medicaid
TNMB2405454OtherDEA #
TN1194018622OtherINDIVIDUAL NPI
TNINDIVIDUAL # Q006027Medicaid
TNINDIVIDUAL # Q006027Medicaid