CUMBERLAND PEDIATRIC ASSOCIATES PC NPI 1104964576

NPI Information

  • NPI: 1104964576
  • Provider Name: CUMBERLAND PEDIATRIC ASSOCIATES PC
  • Classification: Clinic/Center - 261QP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • Address: 1029 W MAIN ST
    SUITE M
    LEBANON, TN
    ZIP 37087
  • Phone: (615) 453-1252

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NPI Details

CUMBERLAND PEDIATRIC ASSOCIATES PC is a primary care clinic center in Lebanon, TN. CUMBERLAND PEDIATRIC ASSOCIATES PC NPI is 1104964576. The provider is registered as an organization entity type.

The provider's business location address is:

1029 W MAIN ST
SUITE M
LEBANON, TN
ZIP 37087-351
Phone: (615) 453-1252
Fax: (615) 453-1286

The provider's authorized official is Charles Andrew Jordan .
The authorized official title is Physician and has the following contact phone number (615) 453-1252.

The enumeration date for this NPI number is 2/1/2007 and was last updated on 3/16/2025.

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
1261QP2300XClinic/CenterPrimary CareYes
2261QR1300XClinic/CenterRural HealthNo

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
13713897MEDICAIDTENNESSEE

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: 11/21/2025

NPI Synchronization or Removal

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