Organization Active NPI

Tipton County Integrated Medicine

  • General Practice Physician
  • Covington, TN
National Provider Identifier
1093265605
Registry record updated Mar 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
TIPTON COUNTY INTEGRATED MEDICINE
Practice address
201 W Pleasant Avenue
Covington, TN 38019-2538
Phone
(901) 475-1100
NPI assigned
Oct 6, 2016
Last updated
Mar 2, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2017

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

Authorized official

Name
Breck BeasleyNPI 1861528481
Title
Manager
Phone
(901) 475-1100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X
Internal Medicine Physician 207R00000X
General Practice Physician 208D00000X Primary

Addresses

Primary practice location

201 W Pleasant Avenue
Covington, TN 38019-2538

Mailing address

201 W Pleasant Ave
Covington, TN 38019-2538
Phone (901) 475-1100

National Provider Directory

National Provider Directory

Locations

201 W Pleasant Ave
Covington, TN 38019
Phone (901) 475-1100

210 W Pleasant Ave
Covington, TN 38019
Phone (901) 475-1100

Practitioners & affiliated clinicians

Practitioners 2

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": "1475712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488412800000",
    "number": "1093265605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 W PLEASANT AVE",
            "city": "COVINGTON",
            "state": "TN",
            "postal_code": "380192538",
            "telephone_number": "901-475-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 W PLEASANT AVENUE",
            "city": "COVINGTON",
            "state": "TN",
            "postal_code": "380192538",
            "telephone_number": "901-475-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIPTON COUNTY INTEGRATED MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-06",
        "last_updated": "2017-03-02",
        "status": "A",
        "authorized_official_last_name": "BEASLEY",
        "authorized_official_first_name": "BRECK",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "901-475-1100"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2017; 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.