NPI |
1124613799 |
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. |
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). |
Employer Identification Number EIN |
|
The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified. |
Provider Organization Name Legal Business Name |
URGENT SPECIALTY ASSOCIATES OF TENNESSEE PLLC |
The name of the organization provider. If the provider is an organization, this is the legal business name. |
Provider First Line Business Practice Location Address |
1700 MEDICAL CENTER PKWY |
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. |
Provider Business Practice Location Address City Name |
MURFREESBORO |
The last name of the provider. If the provider is an individual, this is the legal name. |
Provider Business Practice Location Address State Name |
TN |
The first name of the provider, if the provider
is an individual. |
Provider Business Practice Location Address Postal Code |
371292245 |
The middle name of the provider, if the provider
is an individual. |
Provider Business Practice Location Address Country Code If outside U S |
US |
The abbreviations for professional degrees or credentials used or held by the provider,
if the provider is an individual. Examples
are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations
will not be verified by NPS. |
Provider Business Practice Location Address Telephone Number |
2397905582 |
Other last name by which the provider being identified is or has been known. |
Provider Business Practice Location Address Fax Number |
2397905582 |
Other first name by which the provider being identified is or has been known (if an individual). This may be the same as the ‘‘Provider first name’’ if the provider is or has been known by a different last name only. |
Provider Enumeration Date |
3/5/2021 |
Other middle name by which the provider being identified is or has been known (if an individual). This may be the same as the ‘‘Provider middle name’’ if the provider
is or has been known by a different last name only. |
Last Update Date |
9/30/2021 |
The date that a record was last updated or changed. |
Authorized Official Last Name |
JOSEPHS |
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider. |
Authorized Official First Name |
JOHN |
The first name of the authorized official. |
Authorized Official Middle Name |
D |
The city name in the location address of the provider being identified. |
Authorized Official Title or Position |
PRESIDENT |
The State code in the location of the provider
being identified. |
Authorized Official Telephone Number |
4697668747 |
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. |
Healthcare Provider Taxonomy Code 1 |
2086S0127X |
The country code in the location address of the provider being identified. |
Healthcare Provider Primary Taxonomy Switch 1 |
Y |
The telephone number associated with the location address of the provider being identified. |
Is Organization Subpart |
N |
The date the provider was assigned a unique identifier (assigned an NPI). |
Authorized Official Name Prefix Text |
DR. |
The date that a record was last updated or changed. |
Authorized Official Credential Text |
MD |
|
Healthcare Provider Taxonomy Group 1 |
193200000X MULTI-SPECIALTY GROUP |
|
NPI Certification Date |
9/30/2021 |
|