Middle Tennessee and Adolescent Medicine P.C.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

MD023656 Issued in TN

Legal business name

MIDDLE TENNESSEE AND ADOLESCENT MEDICINE P.C.

Practice address

100 Physicians Way
Suite 200
Lebanon, TN 37090-8102

Phone

(615) 449-5611

Fax

(615) 443-0571

NPI assigned

Apr 3, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Stephen Harmon Claycomb, M.D.

Title

President

Phone

(615) 449-5611

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210118400000",
    "number": "1073634085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PHYSICIANS WAY",
            "address_2": "SUITE 200",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370908102",
            "telephone_number": "615-449-5611",
            "fax_number": "615-443-0571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PHYSICIANS WAY",
            "address_2": "SUITE 200",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370908102",
            "telephone_number": "615-449-5611",
            "fax_number": "615-443-0571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDDLE TENNESSEE AND ADOLESCENT MEDICINE P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2008-05-07",
        "status": "A",
        "authorized_official_last_name": "CLAYCOMB",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "HARMON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-449-5611",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "TN",
            "license": "MD023656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Petrina L. Meyer, O.D.
• Mary Reese Micinski, SLP
• Mid-South Ambulance Service
• Mid-South Cardiology
• Mid-State Oral Surgery of Lebanon
• Middle Tennessee Anesthesia Providers, PLLC
• Middle Tennessee Behavioral Health
• Middle Tennessee Counseling Services, Inc
• Middle Tennessee Occupational Medicine
• Middle Tennessee Pediatric Services, PLLC

• Clinic/Center in Lebanon, TN
• Providers in Lebanon, TN by specialty
• Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2008; 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.