Tennessee Telederm PLLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

TENNESSEE TELEDERM PLLC

Practice address

3500 John a Merritt Blvd
Nashville, TN 37209

Phone

(615) 513-1959

Fax

(615) 513-0498

NPI assigned

Nov 6, 2020

Organization subpart

No

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

Authorized official

Name

Stacy Snyder

Title

Credentialing Manager

Phone

(480) 565-1132

Specialties & licenses 1

Addresses

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/22497/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1604620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604620800000",
    "number": "1114528049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73 WHITE BRIDGE PIKE STE 103",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372051444",
            "telephone_number": "615-513-1959",
            "fax_number": "615-513-0498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 JOHN A MERRITT BLVD",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "37209",
            "telephone_number": "615-513-1959",
            "fax_number": "615-513-0498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TENNESSEE TELEDERM PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-06",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-04",
        "status": "A",
        "authorized_official_last_name": "SNYDER",
        "authorized_official_first_name": "STACY",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "480-565-1132"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Nashville, TN
• Providers in Nashville, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.