NPIMap

Organization Active NPI

Timber Creek Medical

  • General Practice Physician
  • Cordova, TN
National Provider Identifier
1093158958
Registry record updated Apr 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
TIMBER CREEK MEDICAL
Practice address
150 Timber Creek Dr
Suite 2
Cordova, TN 38018-4236
Phone
(901) 412-1542
NPI assigned
Apr 10, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2013

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

Authorized official

Name
Mrs. Cristal Wooster
Title
Owner
Phone
(901) 412-1542

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

150 Timber Creek Dr
Suite 2
Cordova, TN 38018-4236

Mailing address

PO Box 1392
Cordova, TN 38088-1392

National Provider Directory

National Provider Directory

Locations

150 Timber Creek Dr
Ste 2
Cordova, TN 38018
Phone (901) 207-6702

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1365552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365552000000",
    "number": "1093158958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1392",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380881392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 TIMBER CREEK DR",
            "address_2": "SUITE 2",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380184236",
            "telephone_number": "901-412-1542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIMBER CREEK MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-10",
        "last_updated": "2013-04-10",
        "status": "A",
        "authorized_official_last_name": "WOOSTER",
        "authorized_official_first_name": "CRISTAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "901-412-1542",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cordova, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2013; 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.