TOP FLIGHT MEDICAL GROUP LLC - NPI NUMBER 1588948459

Summary

Provider Name: TOP FLIGHT MEDICAL GROUP LLC

NPI Number: 1588948459

Clasification: Specialist (174400000X)

Address:
2555 N WASHINGTON AVE
BROWNSVILLE, TN
ZIP 38012

Phone Number: (615) 340-3436



Detailed Information

TOP FLIGHT MEDICAL GROUP LLC is a specialist in Brownsville, TN. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. The assigned NPI number for this provider is 1588948459 and is registered as an organization entity type and is a single specialty group.

The provider's business address is:

2555 N WASHINGTON AVE
BROWNSVILLE, TN
ZIP 38012-610
Phone: (615) 340-3436
Fax: (615) 340-3438

The provider's authorized official is Sekou Molette .
The authorized official title is Owner and has the following contact phone number (615) 340-3436.

The enumeration date for this NPI number is 10/10/2011 and was last updated on 10/10/2011.

Map - Location of Practice

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Taxonomy Codes

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 174400000X Specialist Yes

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1588948459 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 2 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Employer Identification Number EIN The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
4 Provider Organization Name Legal Business Name TOP FLIGHT MEDICAL GROUP LLC The name of the organization provider. If the provider is an organization, this is the legal business name.
5 Provider First Line Business Practice Location Address 2555 N WASHINGTON AVE The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
6 Provider Business Practice Location Address City Name BROWNSVILLE The city name in the location address of the provider being identified.
7 Provider Business Practice Location Address State Name TN The State code in the location of the provider being identified.
8 Provider Business Practice Location Address Postal Code 380121610 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
9 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
10 Provider Business Practice Location Address Telephone Number 6153403436 The telephone number associated with the location address of the provider being identified.
11 Provider Business Practice Location Address Fax Number 6153403438 The fax number associated with the location address of the provider being identified.
12 Provider Enumeration Date 10/10/2011 The date the provider was assigned a unique identifier (assigned an NPI).
13 Last Update Date 10/10/2011 The date that a record was last updated or changed.
14 Authorized Official Last Name MOLETTE The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
15 Authorized Official First Name SEKOU The first name of the authorized official.
16 Authorized Official Title or Position OWNER The title or position of the authorized official.
17 Authorized Official Telephone Number 6153403436 The 10-position telephone number of the authorized official.
18 Healthcare Provider Taxonomy Code 1 174400000X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
19 Healthcare Provider Primary Taxonomy Switch 1 Y
20 Is Organization Subpart N
21 Authorized Official Name Prefix Text DR.
22 Authorized Official Credential Text MD
23 Healthcare Provider Taxonomy Group 1 193400000X SINGLE SPECIALTY GROUP

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This page was last updated on: 3/10/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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