NPIMap

Organization Active NPI

Middle Tennessee Surgical Specialists, LLC

  • Specialist
  • Cookeville, TN
National Provider Identifier
1134212640
Registry record updated Feb 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
MIDDLE TENNESSEE SURGICAL SPECIALISTS, LLC
Practice address
203 N. Cedar Avenue
Suite a
Cookeville, TN 38501
Phone
(931) 528-1992
Fax
(931) 526-3694
NPI assigned
Oct 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2010

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

Authorized official

Name
Dr. Scott A Copeland, M.D.NPI 1124111661
Title
Member
Phone
(931) 528-1992

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
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

203 N. Cedar Avenue
Suite a
Cookeville, TN 38501

Mailing address

203 N. Cedar Avenue
Suite a
Cookeville, TN 38501
Phone (931) 528-1992

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040220001055 TN Part B Supplier - Clinic/Group Practice 9133014707 Receives reassigned benefits from 10 practitioners
Practice locations: Cookeville, TN; Smithfield, TN

National Provider Directory

National Provider Directory

Locations

251 W 3rd St
Ste 202
Cookeville, TN 38501
Phone (931) 528-1992

203 N Cedar Ave
Cookeville, TN 38501
Phone (931) 528-1992

445 N Cedar Ave
Cookeville, TN 38501
Phone (931) 528-5787

203 N Cedar Ave
Ste A
Cookeville, TN 38501
Phone (931) 528-1992

205 N Cedar Ave
Cookeville, TN 38501
Phone (931) 783-2626

Practitioners & affiliated clinicians

Practitioners 12

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": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265760000000",
    "number": "1134212640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 N. CEDAR AVENUE",
            "address_2": "SUITE A",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "38501",
            "telephone_number": "931-528-1992",
            "fax_number": "931-526-3694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 N. CEDAR AVENUE",
            "address_2": "SUITE A",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "38501",
            "telephone_number": "931-528-1992",
            "fax_number": "931-526-3694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDDLE TENNESSEE SURGICAL SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2010-02-10",
        "status": "A",
        "authorized_official_last_name": "COPELAND",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "931-528-1992",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cookeville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2010; 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.