Organization Active NPI

Neuro Resource PC

  • Neurology Physician
  • Nashville, TN
National Provider Identifier
1114041548
Registry record updated Sep 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
012943 Issued in TN
Legal business name
NEURO RESOURCE PC
Practice address
3443 Dickerson Pike Ste 300
Nashville, TN 37207-2523
Phone
(615) 868-0200
Fax
(615) 865-5999
NPI assigned
Mar 19, 2007
Organization subpart
Yes
Parent organization
NEURO RESOURCE PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 15, 2011

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

Authorized official

Name
Paulo Acosta, MD
Title
Owner
Phone
(615) 868-0200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X 012943 TN Primary

Addresses

Primary practice location

3443 Dickerson Pike Ste 300
Nashville, TN 37207-2523

Mailing address

3443 Dickerson Pike Ste 300
Nashville, TN 37207-2523
Phone (615) 868-0200

Other identifiers 2

IdentifierTypeStateIssuer
2000950OtherTNBLUE CROSS BLUE SHIELD
3184804MedicaidTN

National Provider Directory

National Provider Directory
Part of
Neuro-Resource PC

Locations

510 Hospital Dr
Ste 540
Madison, TN 37115
Phone (615) 868-0200

Practitioners & affiliated clinicians

Practitioners 3

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": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316044800000",
    "number": "1114041548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3443 DICKERSON PIKE STE 300",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372072523",
            "telephone_number": "615-868-0200",
            "fax_number": "615-865-5999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3443 DICKERSON PIKE STE 300",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372072523",
            "telephone_number": "615-868-0200",
            "fax_number": "615-865-5999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEURO RESOURCE PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NEURO RESOURCE PC",
        "enumeration_date": "2007-03-19",
        "last_updated": "2011-09-15",
        "status": "A",
        "authorized_official_last_name": "ACOSTA",
        "authorized_official_first_name": "PAULO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "615-868-0200",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TN",
            "license": "012943",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "2000950",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3184804",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2011; 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.