NPIMap

Organization Active NPI

State of Tennessee

  • Occupational Therapist
  • Arlington, TN
National Provider Identifier
1013329564
Registry record updated Jun 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
STATE OF TENNESSEE
Practice address
11437 Milton Wilson Rd
Didd West TN Seating and Positioning Clinic
Arlington, TN 38002-4926
Phone
(901) 745-7509
NPI assigned
Jun 2, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2016

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

Authorized official

Name
Mr. Lance Derek Iverson
Title
Deputy Commissioner
Phone
(615) 253-6710

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X Primary

Addresses

Primary practice location

11437 Milton Wilson Rd
Didd West TN Seating and Positioning Clinic
Arlington, TN 38002-4926

Mailing address

400 Deaderick St
Citizens Plaza, 10TH Floor
Nashville, TN 37243-0001
Phone (615) 253-6710

Other identifiers 1

IdentifierTypeStateIssuer
Q017827MedicaidTN

Other names 1

  • Tennessee Department of Intellectual and Developmental Disabilities Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Trousdale County Health202 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 13

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 13

Locations

2530 N Mount Juliet Rd
Mount Juliet, TN 37122
Phone (615) 758-6422

400 Deaderick St
Nashville, TN 37243

400 Deaderick St
Fl 10
Nashville, TN 37243

115 Stewarts Ferry Pike
Nashville, TN 37214
Phone (615) 231-7300

NPI Registry JSON

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

{
    "created_epoch": "1401667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467158400000",
    "number": "1013329564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 DEADERICK ST",
            "address_2": "CITIZENS PLAZA, 10TH FLOOR",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372430001",
            "telephone_number": "615-253-6710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11437 MILTON WILSON RD",
            "address_2": "DIDD WEST TN SEATING AND POSITIONING CLINIC",
            "city": "ARLINGTON",
            "state": "TN",
            "postal_code": "380024926",
            "telephone_number": "901-745-7509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF TENNESSEE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-02",
        "last_updated": "2016-06-29",
        "status": "A",
        "authorized_official_last_name": "IVERSON",
        "authorized_official_first_name": "LANCE",
        "authorized_official_middle_name": "DEREK",
        "authorized_official_title_or_position": "DEPUTY COMMISSIONER",
        "authorized_official_telephone_number": "615-253-6710",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q017827",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tennessee Department of Intellectual and Developmental Disabilities",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Arlington, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2016; 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.