Active NPI
Milan Medical Center, P.C.
- Family Medicine Physician
- Milan, TN
National Provider Identifier
1073739645
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- MILAN MEDICAL CENTER, P.C.
- Practice address
- 6041 Telecom Dr
Milan, TN 38358-3448 - Phone
- (731) 686-1505
- Fax
- (731) 686-8174
- NPI assigned
- Apr 18, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Shirley A Todd
- Title
- Office Manager
- Phone
- (731) 686-1505
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
6041 Telecom Dr
Milan, TN 38358-3448
Mailing address
6041 Telecom Dr
Milan, TN 38358-3448
Phone (731) 686-1505
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3384572 | Medicaid | TN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070907000418 | TN | Part B Supplier - Clinic/Group Practice | 4385737311 |
Receives reassigned benefits from 7 practitioners Practice locations: Milan, TN |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 44D0315699 | Milan Medical Center | Accreditation | Dec 22, 2027 |
National Provider Directory
National Provider DirectoryLocations
6041 Telecom Dr
Milan, TN 38358
Phone (731) 686-1505
Practitioners & affiliated clinicians
Practitioners 7
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Student in an Organized Health Care Education/Training Program
- Milan, TN
- NPI 1699137240
TN
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176854400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1567641600000",
"number": "1073739645",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6041 TELECOM DR",
"city": "MILAN",
"state": "TN",
"postal_code": "383583448",
"telephone_number": "731-686-1505",
"fax_number": "731-686-8174"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6041 TELECOM DR",
"city": "MILAN",
"state": "TN",
"postal_code": "383583448",
"telephone_number": "731-686-1505",
"fax_number": "731-686-8174"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MILAN MEDICAL CENTER, P.C.",
"organizational_subpart": "NO",
"enumeration_date": "2007-04-18",
"last_updated": "2019-09-05",
"status": "A",
"authorized_official_last_name": "TODD",
"authorized_official_first_name": "SHIRLEY",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "731-686-1505"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3384572",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Milan, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.