Mid State Medical Group, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

1782 Issued in TN

Legal business name

MID STATE MEDICAL GROUP, LLC

Practice address

1525 Hunt Club Blvd
Suite 600
Gallatin, TN 37066-6070

Phone

(615) 230-9095

NPI assigned

Aug 8, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Noridia Mauras, D.O.

Title

Owner

Phone

(615) 390-0708

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ashish K Chakravarthy, MD

  • Emergency Medicine Physician
  • Sewanee, TN
  • NPI 1275589145
  NPD (past)

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202947200000",
    "number": "1093725533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 309",
            "city": "GALLATIN",
            "state": "TN",
            "postal_code": "370660309",
            "telephone_number": "615-230-9095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 HUNT CLUB BLVD",
            "address_2": "SUITE 600",
            "city": "GALLATIN",
            "state": "TN",
            "postal_code": "370666070",
            "telephone_number": "615-230-9095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID STATE MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-08",
        "last_updated": "2008-02-14",
        "status": "A",
        "authorized_official_last_name": "MAURAS",
        "authorized_official_first_name": "NORIDIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "615-390-0708",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "1782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3736067",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1093725533",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rodney Brandon Mewbourne, M.D.
• Lindsey M Meyer, DPT
• Michael D. Jessee
• Michael E. Green
• Katharine Michie, MS OTR/L
• Middle Tennessee Chiropractic P.L.L.C.
• Middle Tennessee Nephrology
• Middle Tennessee Orthopaedics PC
• Mandy Lea Middleton
• Erika Mikkelsen, DPT

• Internal Medicine Physician in Gallatin, TN
• Providers in Gallatin, TN by specialty
• Internal Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 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.