NPIMap

Organization Active NPI

Amg-Livingston LLC

Doing business as Upper Cumberland Center for Women

  • Obstetrics & Gynecology Physician
  • Livingston, TN
National Provider Identifier
1154595502
Registry record updated Jun 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
AMG-LIVINGSTON LLC
Doing business as
Upper Cumberland Center for Women
Practice address
700 W Main St
Livingston, TN 38570-1720
Phone
(931) 823-9970
Fax
(931) 823-9006
NPI assigned
Apr 16, 2008
Last updated
Jun 17, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
AMG-LIVINGSTON LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 17, 2008

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

700 W Main St
Livingston, TN 38570-1720

Mailing address

700 W Main St
Livingston, TN 38570-1720
Phone (931) 823-9970

Other names 1

  • Upper Cumberland Center for Women Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031120000923 TN Part B Supplier - Clinic/Group Practice 1052225760 Receives reassigned benefits from 36 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cookeville, TN; Livingston, TN; Celina, TN; Byrdstown, TN

Other NPIs on the same Medicare enrollment 7

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

National Provider Directory

National Provider Directory
Part of
Kenneth Beaty MD

NPI Registry JSON

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

{
    "created_epoch": "1208304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213660800000",
    "number": "1154595502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 W MAIN ST",
            "city": "LIVINGSTON",
            "state": "TN",
            "postal_code": "385701720",
            "telephone_number": "931-823-9970",
            "fax_number": "931-823-9006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W MAIN ST",
            "city": "LIVINGSTON",
            "state": "TN",
            "postal_code": "385701720",
            "telephone_number": "931-823-9970",
            "fax_number": "931-823-9006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMG-LIVINGSTON LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AMG-LIVINGSTON LLC",
        "enumeration_date": "2008-04-16",
        "last_updated": "2008-06-17",
        "status": "A",
        "authorized_official_last_name": "GRACEY",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "615-372-8500"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Upper Cumberland Center for Women",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Livingston, TN

Sources for this page

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