NPIMap

Organization Active NPI

Memorial Drive Family Practice

  • Family Medicine Physician
  • Clarksville, TN
National Provider Identifier
1154318954
Registry record updated Jan 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D0769 Issued in TN
Legal business name
MEMORIAL DRIVE FAMILY PRACTICE
Practice address
306 Landrum PL
Clarksville, TN 37043-4648
Phone
(931) 648-1920
Fax
(931) 503-0346
NPI assigned
Oct 5, 2005
Last updated
Jan 17, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2008

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

Authorized official

Name
Stephan Schott, D.O.NPI 1053308882
Title
Physician
Phone
(931) 648-1920

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X D0769 TN Primary

Addresses

Primary practice location

306 Landrum PL
Clarksville, TN 37043-4648

Mailing address

PO Box 3857
Clarksville, TN 37043-0857
Phone (931) 648-1920

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200528000000",
    "number": "1154318954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3857",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370430857",
            "telephone_number": "931-648-1920",
            "fax_number": "931-503-0346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 LANDRUM PL",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370434648",
            "telephone_number": "931-648-1920",
            "fax_number": "931-503-0346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL DRIVE FAMILY PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-05",
        "last_updated": "2008-01-17",
        "status": "A",
        "authorized_official_last_name": "SCHOTT",
        "authorized_official_first_name": "STEPHAN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "931-648-1920",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "D0769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2008; 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.