NPIMap

Organization Active NPI

Premier Orthopaedics & Sports Medicine, PLC

  • Physical Therapy Clinic/Center
  • Hermitage, TN
National Provider Identifier
1083789176
Registry record updated Sep 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
PREMIER ORTHOPAEDICS & SPORTS MEDICINE, PLC
Practice address
5651 Frist Blvd
Suite 515
Hermitage, TN 37076-2054
Phone
(615) 889-3501
Fax
(615) 889-3349
NPI assigned
Nov 22, 2006
Organization subpart
Yes
Parent organization
PREMIER ORTHOPAEDICS & SPORTS MEDICINE, PLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 20, 2018

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

Authorized official

Name
Amy Benchwick
Title
Director of Credentialing
Phone
(706) 324-6661

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

5651 Frist Blvd
Suite 515
Hermitage, TN 37076-2054

Mailing address

PO Box 370
Fortson, GA 31808-0370
Phone (706) 324-6661

Other identifiers 1

IdentifierTypeStateIssuer
0922510006OtherTNMEDICARE DME

Other names 1

  • Hughston Clinic Orthopaedics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Premier Ortho Sports Med10 organizations share this tax ID, including this one
Part of
Premier Ortho Sports Med

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5651 Frist Blvd
Ste 515
Hermitage, TN 37076
Phone (615) 889-3501

NPI Registry JSON

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537401600000",
    "number": "1083789176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 370",
            "city": "FORTSON",
            "state": "GA",
            "postal_code": "318080370",
            "telephone_number": "706-324-6661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5651 FRIST BLVD",
            "address_2": "SUITE 515",
            "city": "HERMITAGE",
            "state": "TN",
            "postal_code": "370762054",
            "telephone_number": "615-889-3501",
            "fax_number": "615-889-3349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER ORTHOPAEDICS & SPORTS MEDICINE, PLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PREMIER ORTHOPAEDICS & SPORTS MEDICINE, PLC",
        "enumeration_date": "2006-11-22",
        "last_updated": "2018-09-20",
        "status": "A",
        "authorized_official_last_name": "BENCHWICK",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "DIRECTOR OF CREDENTIALING",
        "authorized_official_telephone_number": "706-324-6661"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DME",
            "identifier": "0922510006",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hughston Clinic Orthopaedics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hughston Clinic Orthopaedics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hermitage, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2018; 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.