NPIMap

Organization Active NPI

Smyrna Medical Group LLC

  • Internal Medicine Physician
  • Smyrna, TN
National Provider Identifier
1104856517
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SMYRNA MEDICAL GROUP LLC
Practice address
351 Que Creek Circle
Smyrna, TN 37167
Phone
(615) 459-5796
Fax
(615) 459-5546
NPI assigned
Jul 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Richard P Garvin, MDNPI 1679521058
Title
Managing Member
Phone
(615) 459-5796

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
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

351 Que Creek Circle
Smyrna, TN 37167

Mailing address

PO Box 2367
Murfreesboro, TN 37133
Phone (615) 459-5796

Other identifiers 1

IdentifierTypeStateIssuer
3711354MedicaidTN

National Provider Directory

National Provider Directory

Locations

400 Enon Springs Rd W
Ste 103
Smyrna, TN 37167
Phone (615) 459-5796

Practitioners & affiliated clinicians

Practitioners 10

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

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104856517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2367",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "37133",
            "telephone_number": "615-459-5796",
            "fax_number": "615-459-5546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 QUE CREEK CIRCLE",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "37167",
            "telephone_number": "615-459-5796",
            "fax_number": "615-459-5546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMYRNA MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GARVIN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "615-459-5796",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3711354",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Smyrna, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.