Organization Active NPI

Tennessee Back Pain Center LLC

  • Sports Physician Chiropractor
  • Murfreesboro, TN
National Provider Identifier
1124771118
Registry record updated Mar 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
Legal business name
TENNESSEE BACK PAIN CENTER LLC
Practice address
3242 Memorial Blvd Ste C
Murfreesboro, TN 37129-3233
Phone
(615) 900-5187
Fax
(833) 624-3035
NPI assigned
Jan 31, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2025

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

Authorized official

Name
Teresa Ann Porter, DCNPI 1144980293
Title
Chiropractic Physician
Phone
(615) 900-5187

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
Sports Physician ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NS0005X Primary

Addresses

Primary practice location

3242 Memorial Blvd Ste C
Murfreesboro, TN 37129-3233

Mailing address

475 Swanholme Dr Apt L209
Murfreesboro, TN 37128-1521
Phone (937) 825-0788

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220630002534 TN Part B Supplier - Clinic/Group Practice 5294115762 Receives reassigned benefits from 2 practitioners
Practice locations: Murfreesboro, TN

National Provider Directory

National Provider Directory

Locations

304 Fortress Blvd
Murfreesboro, TN 37128
Phone (615) 900-5187

3242 Memorial Blvd
Ste C
Murfreesboro, TN 37129
Phone (615) 900-5187

Practitioners & affiliated clinicians

Practitioners 4

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": "1643587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742947200000",
    "number": "1124771118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 SWANHOLME DR APT L209",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371281521",
            "telephone_number": "937-825-0788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3242 MEMORIAL BLVD STE C",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371293233",
            "telephone_number": "615-900-5187",
            "fax_number": "833-624-3035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TENNESSEE BACK PAIN CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-31",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A",
        "authorized_official_last_name": "PORTER",
        "authorized_official_first_name": "TERESA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CHIROPRACTIC PHYSICIAN",
        "authorized_official_telephone_number": "615-900-5187",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murfreesboro, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.