OLD HICKORY EMERGENCY PHYSICIANS (NPI# 1679771240) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679771240 |
| Entity Type | Organization |
| Organization Name | OLD HICKORY EMERGENCY PHYSICIANS |
| Practice Address |
500 Hospital Dr Madison TN 37115-5031 |
| Mailing Address |
Po Box 13858 Philadelphia PA 19101-3858 |
| Practice Telephone | 6158650300 |
| Practice Fax Number | 6153128317 |
| Mailing Telephone | 8003550808 |
| Mailing Fax Number | 2158342862 |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | JENNIFER PROVASNIK (SUPERVISOR OF PROVIDER ENROLLMENT) |
| Authorized Official Telephone | 8003550808 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 3726452 | 05 |
| Street Address |
500 HOSPITAL DR |
| City | MADISON |
| State | TN |
| Zip Code | 37115-5031 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467087635 | Timothy Andrew Clouse | Social Worker | 500 Hospital Dr, Madison, TN 37115-5031 | 2020-03-09 |
| 1912316589 | Valarie Harris | Counselor | 500 Hospital Dr, Madison, TN 37115-5031 | 2014-08-07 |
| 1881985497 | Joseph Vasant Pandit | Pharmacist | 500 Hospital Dr, Madison, TN 37115-5031 | 2011-04-29 |
| 1033436050 | Lindsay Kishanna Evans-mitchell | Psychiatry & Neurology | 500 Hospital Dr, Madison, TN 37115-5031 | 2010-04-29 |
| 1710086699 | Mary Alice Erlewine | Physical Therapy Assistant | 500 Hospital Dr, Madison, TN 37115-5031 | 2006-09-21 |
| 1467495796 | Tcmc Madison-portland, Inc. | General Acute Care Hospital | 500 Hospital Dr, Madison, TN 37115-5031 | 2006-06-14 |
| 1376586602 | Tcmc Madison-portland, Inc. | Rehabilitation Unit | 500 Hospital Dr, Madison, TN 37115-5031 | 2006-06-14 |
| 1013957968 | Tcmc Madison-portland, Inc. | Rehabilitation Unit | 500 Hospital Dr, Madison, TN 37115-5031 | 2006-06-08 |
| 1245271741 | Tcmc Madison-portland, Inc. | Psychiatric Unit | 500 Hospital Dr, Madison, TN 37115-5031 | 2006-06-08 |
| 1114968526 | Hti Memorial Hospital Corporation | Psychiatric Unit | 500 Hospital Dr, Madison, TN 37115-5031 | 2006-06-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023675212 | Kennedy Wayne Germany Jr. | Specialist/Technologist | 813 Seashell Cove, Madison, TN 37115 | 2019-05-22 |
| 1497211387 | Latasha Monique Williams | Social Worker | Patriot Place (va), 314 Williams Avenue, Ste. 100, Madison, TN 37115 | 2019-02-15 |
| 1659866481 | Amanda Elliott | Pharmacist | 109 Gallatin Rd, Madison, TN 37115 | 2018-06-25 |
| 1760938492 | Larry Cox | Case Manager/Care Coordinator | 620 S. Gallatin Pike, Madison, TN 37115 | 2016-09-01 |
| 1407202799 | National Vision, Inc. | Technician/Technologist | 1785 Gallatin Pike N, Madison, TN 37115 | 2016-05-05 |
| 1992190193 | Emily Tibbs | Case Manager/Care Coordinator | 620 Gallatin Pike, Madison, TN 37115 | 2015-04-03 |
| 1164829982 | Laura Boswell | Case Manager/Care Coordinator | 620 Gallatin Pike South, Madison, TN 37115 | 2014-11-21 |
| 1720498058 | Edward Andrew Roberts | Chiropractor | 1710 Gallatin Pike N, Madison, TN 37115 | 2014-05-08 |
| 1700296217 | Lamonia Merritt | Student in an Organized Health Care Education/Training Program | 645 Cheyenne Blvd, Madison, TN 37115 | 2014-05-06 |
| 1629497656 | Corey Joseph Cloud | Dentist | 500 Lentz Dr Ste 40, Madison, TN 37115 | 2014-04-07 |
| Find all providers in zip 37115 | ||||
| Taxonomy Code | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740642180 | Derek Hunt | Emergency Medicine | 709 Sugar Bend Cir Sw, Madison, AL 35756-5311 | 2016-03-24 |
| 1699703389 | Lisa D Anderson | Emergency Medicine | 935 Highway 51, Madison, MS 39110-8407 | 2006-06-29 |
| 1629055124 | Thomas F Bugliosi | Emergency Medicine | 202 S Park St, Madison, WI 53715-1507 | 2005-12-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992182224 | Steven T. Haywood | Emergency Medicine | 1120 Skyline Dr, Johnson City, TN 37604-3779 | 2015-05-06 |
| 1003173923 | Harold Earl Smith | Emergency Medicine | 2277 Stewarts Ferry Pike, Hermitage, TN 37076-3902 | 2012-04-17 |
| 1942538459 | Michael Alan Dorrity | Emergency Medicine | 2952 Gardens Way, Memphis, TN 38111-2647 | 2009-11-20 |
| 1730322389 | James Robert Davenport | Emergency Medicine | 209 Light Hall, Nashville, TN 37212 | 2009-04-13 |
| 1598938060 | William John Heerman | Emergency Medicine | Vanderbilt Medical Center 1215 21st Ave S, 7th Floor, Mce, Suite 2, North Tower, Nashville, TN 37232-0001 | 2008-04-07 |
| 1669556148 | Adejoke Foluke Aina-babalola | Emergency Medicine | 6716 Nolensville Pike, Suite 240, Brentwood, TN 37027-8805 | 2006-10-24 |
| 1003912148 | Richard W. Babin | Emergency Medicine | 506 S Yates Rd, Memphis, TN 38120-2436 | 2006-09-16 |
| 1679502314 | Meifung Kerley | Emergency Medicine | Lamont Street, Mountain Home, TN 37684 | 2006-07-03 |
| 1376579730 | Douglas Wister Ligon | Emergency Medicine | 4895 East Main St, Ste A, Erin, TN 37061 | 2006-06-25 |
| 1518912195 | Ralf Joffe | Emergency Medicine | 522 Treyburn Dr, Knoxville, TN 37934-0899 | 2006-05-23 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.