NPIMap

Organization Active NPI

Mid South Psychiatric Associates

  • Prescribing (Medical) Psychologist
  • Murfreesboro, TN
National Provider Identifier
1013109511
Registry record updated Aug 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prescribing (Medical) PsychologistTaxonomy code 103TP0016X
License
MD0000020287 Issued in TN
Legal business name
MID SOUTH PSYCHIATRIC ASSOCIATES
Practice address
1830 Heritage Park PLZ
Murfreesboro, TN 37129-1575
Phone
(615) 895-8104
Fax
(615) 895-7903
NPI assigned
Aug 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2007

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

Authorized official

Name
Ahmed I Farooque, MD
Title
Partner
Phone
(615) 895-8104

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Prescribing (Medical) PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TP0016X MD0000020287 TN Primary
Prescribing (Medical) PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TP0016X MD0000018343 TN
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 4196 TN

Addresses

Primary practice location

1830 Heritage Park PLZ
Murfreesboro, TN 37129-1575

Mailing address

1830 Heritage Park PLZ
Murfreesboro, TN 37129-1575
Phone (615) 895-8104

Other identifiers 4

IdentifierTypeStateIssuer
1861608895OtherNPI
3706880MedicaidTN
1558479170OtherNPI
1922116649OtherNPI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1187308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187308800000",
    "number": "1013109511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1830 HERITAGE PARK PLZ",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371291575",
            "telephone_number": "615-895-8104",
            "fax_number": "615-895-7903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1830 HERITAGE PARK PLZ",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371291575",
            "telephone_number": "615-895-8104",
            "fax_number": "615-895-7903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID SOUTH PSYCHIATRIC ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-17",
        "last_updated": "2007-08-17",
        "status": "A",
        "authorized_official_last_name": "FAROOQUE",
        "authorized_official_first_name": "AHMED",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "615-895-8104",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "103TP0016X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "TN",
            "license": "MD0000020287",
            "primary": true
        },
        {
            "code": "103TP0016X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "TN",
            "license": "MD0000018343",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "4196",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1861608895",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3706880",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1558479170",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1922116649",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Murfreesboro, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 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.