Organization Active NPI

Long Hollow Family Practice

  • Family Medicine Physician
  • Goodlettsville, TN
National Provider Identifier
1093928707
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LONG HOLLOW FAMILY PRACTICE
Practice address
450 Professional Park Dr
Goodlettsville, TN 37072-2180
Phone
(615) 859-1440
Fax
(615) 859-0145
NPI assigned
May 8, 2007
Last updated
Feb 13, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2025

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

Authorized official

Name
Dr. John E Baites Jr., M.D.NPI 1801866199
Title
President
Phone
(615) 859-1440

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

450 Professional Park Dr
Goodlettsville, TN 37072-2180

Mailing address

PO Box 710
Goodlettsville, TN 37070-0710
Phone (615) 859-1440

Other practice location 1

740 Conference Dr
Goodlettsville, TN 37072-1915
Phone (615) 859-1440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090511000284 TN Part B Supplier - Clinic/Group Practice 7810984440 Receives reassigned benefits from 5 practitioners
Practice locations: Goodlettsville, TN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D0712431Long Hollow Family Practice PC450 Professional Park Dr, Goodlettsville, TN 37072Certificate of waiverApr 30, 2027

National Provider Directory

National Provider Directory

Locations

450 Professional Park Dr
Goodlettsville, TN 37072
Phone (615) 330-7059

450 Professional Park Dr
Ste C
Goodlettsvlle, TN 37072
Phone (615) 851-5140

Practitioners & affiliated clinicians

Practitioners 10

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": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739404800000",
    "number": "1093928707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 710",
            "city": "GOODLETTSVILLE",
            "state": "TN",
            "postal_code": "370700710",
            "telephone_number": "615-859-1440",
            "fax_number": "615-859-0145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 PROFESSIONAL PARK DR",
            "city": "GOODLETTSVILLE",
            "state": "TN",
            "postal_code": "370722180",
            "telephone_number": "615-859-1440",
            "fax_number": "615-859-0145"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "740 Conference Dr",
            "address_purpose": "LOCATION",
            "city": "Goodlettsville",
            "state": "TN",
            "postal_code": "370721915",
            "country_code": "US",
            "telephone_number": "615-859-1440",
            "fax_number": "615-859-0145",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LONG HOLLOW FAMILY PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-08",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A",
        "authorized_official_last_name": "BAITES",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-859-1440",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodlettsville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2025; 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.

Verify at the official NPI Registry.