CLARKSVILLE PHYSICIAN SERVICES, LLC — NPI 1992077077 (Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center in DOVER, TN)

CMS-1500 Box 24J / 33a • NPI

1992077077

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

261QR1300X (CMS B4[14])

Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center

Box 32 Service Location & ZIP+4

133 DR ROBERT H LEE ROAD, DOVER, TN, 37058-3750

✓ 9-Digit EDI 837 ZIP+4 (37058-3750)

Practice Phone & Referral Fax

(931) 232-5141

Fax: (931) 232-3905

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1992077077 (CLARKSVILLE PHYSICIAN SERVICES, LLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1992077077` (NPI-2 Organization / Facility)
Provider / Legal Name	CLARKSVILLE PHYSICIAN SERVICES, LLC
Plain-English Specialty	Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center NUCC Code: `261QR1300X` (Clinic/Center, Rural Health)
Certifying / Licensing Body	Accreditation Association for Ambulatory Health Care (AAAHC) / CMS
Practice Location Address	133 DR ROBERT H LEE ROAD, DOVER, TN, 37058-3750
Practice Telephone / Fax	Tel: (931) 232-5141 \| Fax: (931) 232-3905
Administrative Mailing Address	3841 GREEN HILLS VILLAGE DR STE 200, NASHVILLE, TN, 37215-2691
Enumeration & Last Sync	Enumerated: 2012-02-03 \| CMS Record Updated: 2026-02-03
Authorized Official	WENDY MONACI (President)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

133 DR ROBERT H LEE ROAD, DOVER, TN, 37058-3750

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Plain-English Taxonomy & CMS Crosswalk (261QR1300X)

What Does Taxonomy Code 261QR1300X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 261QR1300X translates to:
"Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center"

CMS-1500 Medicare Specialty Crosswalk: CMS Code B4[14] (Rural Health Clinic)
Certifying / Accrediting Authority: Accreditation Association for Ambulatory Health Care (AAAHC) / CMS
Clinical Scope: Same-day outpatient consultations, urgent walk-in medical care, vaccinations, and day-case diagnostic procedures.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (CLARKSVILLE PHYSICIAN SERVICES, LLC)

Typical CPT / Diagnostic Procedures:

Walk-In Urgent Care Evaluation, Point-of-Care Testing & X-Ray
Same-Day Ambulatory Endoscopy, Cataract & Minor Surgical Procedures

Common Therapeutic Classes:

Outpatient Oral Antimicrobials, Analgesics, Nebulizers & Vaccines

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`261QR1300X` — Clinic/Center, Rural Health Plain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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CLARKSVILLE PHYSICIAN SERVICES, LLC (NPI #1992077077)