GETHSEMANE CARDIOVASCULAR CLINIC NPI 1407865785

NPI Information

NPI: 1407865785
Provider Name: GETHSEMANE CARDIOVASCULAR CLINIC
Classification: Internal Medicine - 207RC0000X
Entity Type: Organization

Specialization: Cardiovascular Disease

CLIA Number: 44D2138733

Address:
1602 W NORTHFIELD BLVD
SUITE 511 & 512
MURFREESBORO, TN
ZIP 37129
Phone: (615) 494-1255
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GETHSEMANE CARDIOVASCULAR CLINIC is a cardiovascular disease internal medicine in Murfreesboro, TN. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. GETHSEMANE CARDIOVASCULAR CLINIC NPI is 1407865785. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1602 W NORTHFIELD BLVD
SUITE 511 & 512
MURFREESBORO, TN
ZIP 37129-057
Phone: (615) 494-1255
Fax: (615) 896-0403

The provider's authorized official is Paul A Jackson .
The authorized official title is Owner and has the following contact phone number (615) 494-1255.

The CLIA number assigned to this NPI record is 44D2138733 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/5/2006 and was last updated on 6/11/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RC0000X	Internal Medicine	Cardiovascular Disease	MD38872	TENNESSEE	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	MD38872	OTHER	TENNESSEE	MD LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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