Clarksville Health System GP

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

Legal business name

CLARKSVILLE HEALTH SYSTEM GP

Practice address

1771 Madison St
Clarksville, TN 37043-4990

Phone

(931) 552-6622

Fax

(931) 551-1027

NPI assigned

Aug 2, 2006

Organization subpart

Yes

Parent organization

CLARKSVILLE HEALTH SYSTEM GPAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Rebecca Hurley

Title

Senior Vice President

Phone

(214) 473-3993

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Gateway Health System Doing business as

Part of

Clarksville Health System LLC

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Clarksville Health System, LLC

  • General Acute Care Hospital
  • Clarksville, TN
  • NPI 1285689794

  Member Of

  NPD member

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Clarksville Health System GP

  • Hospitalist Physician
  • Clarksville, TN
  • NPI 1952581761
  NPPES parent name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185235200000",
    "number": "1003823097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 403765",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303843765",
            "telephone_number": "931-552-6622",
            "fax_number": "931-551-1027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1771 MADISON ST",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370434990",
            "telephone_number": "931-552-6622",
            "fax_number": "931-551-1027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARKSVILLE HEALTH SYSTEM GP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CLARKSVILLE HEALTH SYSTEM GP",
        "enumeration_date": "2006-08-02",
        "last_updated": "2007-07-24",
        "status": "A",
        "authorized_official_last_name": "HURLEY",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "214-473-3993"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiologist Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003823097",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gateway Health System",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Clarksville Eye Clinic LLC
• Clarksville Eye Surgery Center
• Clarksville Family Chiropractic
• Clarksville Family Therapy
• Clarksville Gastroenterology PC
• Clarksville Health System GP
• Clarksville Health System GP
• Clarksville Health System GP
• Clarksville Health System, LLC
• Clarksville Health System, LLC

• Anesthesiology Physician in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Anesthesiology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.