NPIMap

Organization Active NPI

Liberty Healthcare Partners

  • Primary Care Clinic/Center
  • Hixson, TN
National Provider Identifier
1114702149
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
LIBERTY HEALTHCARE PARTNERS
Practice address
1017 Executive Dr Ste 101
Hixson, TN 37343-7911
Phone
(423) 870-1999
NPI assigned
Aug 28, 2023
Organization subpart
Yes
Parent organization
LIBERTY HEALTHCARE PARTNERSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Authorized official

Name
Denise Croft
Title
Credentialing Specialist
Phone
(423) 763-4576

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

1017 Executive Dr Ste 101
Hixson, TN 37343-7911

Mailing address

1017 Executive Dr Ste 101
Hixson, TN 37343-7911
Phone (423) 498-5839

National Provider Directory

National Provider Directory
Tax ID family
Liberty Healthcare Partners2 organizations share this tax ID, including this one
Part of
Liberty Healthcare Partners

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

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": "1693180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695686400000",
    "number": "1114702149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 EXECUTIVE DR STE 101",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373437911",
            "telephone_number": "423-498-5839",
            "fax_number": "423-449-8258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1017 EXECUTIVE DR STE 101",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373437911",
            "telephone_number": "423-870-1999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY HEALTHCARE PARTNERS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIBERTY HEALTHCARE PARTNERS",
        "enumeration_date": "2023-08-28",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A",
        "authorized_official_last_name": "CROFT",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "423-763-4576"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hixson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2023; 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.