Data Notice: All results sourced from the public CMS NPPES NPI Registry (45 CFR Part 162), for healthcare administrative use only (credentialing, billing, insurance verification). Not for law enforcement or legal proceedings. Not affiliated with CMS, HHS, or the US Government. Verify critical details at npiregistry.cms.hhs.gov. No queries stored.
Export Provider Record NPI 1407121551
Amen Clinic Pc
Organization Subpart: NO
Active
NPI Number1407121551
NPI TypeNPI-2 Organization
SpecialtyFamily Medicine
Provider Details
NPI1407121551
NPI TypeNPI-2 Organization
StatusActive
Enumeration Date2012-03-21
Last Updated2018-06-27
Authorized OfficialEzekiel Adetunji
OWNER
Phone: 7313003168
Mailing AddressPo Box 12485
Jackson, TN 38308-0143
United States
Phone: (731) 300-3168 | Fax: (731) 300-3169
📍 View Map
Primary Practice Address150 Murray Guard Dr
Jackson, TN 38305
United States
Phone: (731) 300-3168 | Fax: (731) 300-3169
📍 View Map
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
Yes207Q00000X – Family Medicine--
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About NPI 1407121551

Amen Clinic Pc is an organization registered in the CMS NPPES NPI Registry with NPI number 1407121551. The primary specialty listed is Family Medicine. The organization is located in Jackson, TN. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2012-03-21. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1407121551?

NPI 1407121551 belongs to Amen Clinic Pc, a Family Medicine in Jackson, TN. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.

Is NPI 1407121551 active?

The current status of NPI 1407121551 in the NPPES registry is Active. The record was last updated on 2018-06-27.

What specialty is NPI 1407121551?

NPI 1407121551 is classified under the taxonomy Family Medicine. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1407121551?

You can verify NPI 1407121551 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1407121551?

The primary practice address on file for NPI 1407121551 is 150 Murray Guard Dr, Jackson, TN 38305. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1407121551 issued?

NPI 1407121551 was first issued (enumerated) on 2012-03-21. The NPPES record was last updated on 2018-06-27.

Practice Location Map

Amen Clinic Pc is located at 150 Murray Guard Dr, Jackson, TN. Use the map below to find directions or verify the practice location.

📍 150 Murray Guard Dr, Jackson, TN 38305  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Amen Clinic Pc. All records sourced from the CMS NPPES registry.

Data Verified from CMS NPPES Last synced: 2026-08-25 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162