NPIMap

Amg -Southern Tennessee LLC

Organization Active NPI General Practice Physician · Winchester, TN

NPI 1154373512 · NPPES record last updated Jun 17, 2008

Key facts

NPI
1154373512
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Physician 208D00000X
Legal business name
AMG -SOUTHERN TENNESSEE LLC
Practice address
155 Hospital Rd
Suite B
Winchester, TN 37398-2494
Phone
(931) 962-4040
Fax
(931) 962-2277
NPI assigned
May 16, 2006
Organization subpart
Yes
Parent organization (as reported)
AMG- SOUTHERN TENNESSEE LLC

Authorized official

Name
William Gracey
Title
Coo
Phone
(615) 372-8500

Other NPIs on the same Medicare enrollment 41

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 41

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TN

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20041013001206 TN Part B Supplier - Clinic/Group Practice 5991765943 Receives reassigned benefits from 112 practitioners
41 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Tullahoma, TN; Winchester, TN; Decherd, TN; Estill Springs, TN; Fayetteville, TN; Huntland, TN; Lawrenceburg, TN; Lynchburg, TN…

National Provider Directory

Part of
Amg-Southern Tennessee LLC

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 208D00000X Yes

Addresses

Primary practice location

155 Hospital Rd
Suite B
Winchester, TN 37398-2494

Mailing address

155 Hospital Rd
Suite B
Winchester, TN 37398-2494
Phone (931) 962-4040

Other identifiers

IdentifierTypeStateIssuer
3716446MedicaidTN

Other names

  • Donald M. Philpott, MD Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 17, 2008.

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213660800000",
    "number": "1154373512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 HOSPITAL RD",
            "address_2": "SUITE B",
            "city": "WINCHESTER",
            "state": "TN",
            "postal_code": "373982494",
            "telephone_number": "931-962-4040",
            "fax_number": "931-962-2277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 HOSPITAL RD",
            "address_2": "SUITE B",
            "city": "WINCHESTER",
            "state": "TN",
            "postal_code": "373982494",
            "telephone_number": "931-962-4040",
            "fax_number": "931-962-2277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMG -SOUTHERN TENNESSEE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AMG- SOUTHERN TENNESSEE LLC",
        "enumeration_date": "2006-05-16",
        "last_updated": "2008-06-17",
        "status": "A",
        "authorized_official_last_name": "GRACEY",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "615-372-8500"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3716446",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Donald M. Philpott, MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Winchester, TN

All providers in Winchester, TN · General Practice Physician in Tennessee

Sources for this page

Verify at the official NPI Registry.