CROSSVILLE ORTHOPAEDICS & SPORTS MEDICINE PLLC NPI 1700097417

NPI Information

  • NPI: 1700097417
  • Provider Name: CROSSVILLE ORTHOPAEDICS & SPORTS MEDICINE PLLC
  • Classification: Specialist - 174400000X
  • Entity Type: Organization
  • Address: 35 TAYLOR AVE
    SUITE 103
    CROSSVILLE, TN
    ZIP 38555
  • Phone: (931) 484-3401

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NPI Details

CROSSVILLE ORTHOPAEDICS & SPORTS MEDICINE PLLC is a specialist in Crossville, 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. CROSSVILLE ORTHOPAEDICS & SPORTS MEDICINE PLLC NPI is 1700097417. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

35 TAYLOR AVE
SUITE 103
CROSSVILLE, TN
ZIP 38555-526
Phone: (931) 484-3401
Fax: (931) 484-3405

The provider's authorized official is Russell Tyson Garland .
The authorized official title is Owner and has the following contact phone number (931) 484-3401.

The enumeration date for this NPI number is 5/24/2007 and was last updated on 11/23/2008.

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
1174400000XSpecialistMD37289TENNESSEEYes

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
13717972MEDICAIDTENNESSEE
25257570001MEDICARE NSCTENNESSEE
33717972MEDICARE ID-TYPE UNSPECIFIEDTENNESSEE
44062795OTHERTENNESSEEBLUE CROSS
5E73443MEDICARE UPINTENNESSEE
6P00047359OTHERTENNESSEEMEDICARE RAILROAD

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: 3/30/2025

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