NPIMap

Organization Active NPI

Ten Broeck Tennessee Physicians Group Inc

  • Adult Mental Health Clinic/Center
  • Salem, IN
National Provider Identifier
1164008553
Registry record updated Mar 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
TEN BROECK TENNESSEE PHYSICIANS GROUP INC
Practice address
911 N Shelby St
Salem, IN 47167-2304
Phone
(812) 883-8583
Fax
(812) 883-8595
NPI assigned
Mar 24, 2021
Last updated
Mar 24, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2021

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

Authorized official

Name
Karissa Hutson
Title
Business Office
Phone
(931) 319-4231

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X NU Primary

Addresses

Primary practice location

911 N Shelby St
Salem, IN 47167-2304

Mailing address

911 N Shelby St
Salem, IN 47167-2304
Phone (812) 883-8583

National Provider Directory

National Provider Directory
Tax ID family
Ten Broeck Tennessee Physicians7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1616544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616544000000",
    "number": "1164008553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 N SHELBY ST",
            "city": "SALEM",
            "state": "IN",
            "postal_code": "471672304",
            "telephone_number": "812-883-8583",
            "fax_number": "812-883-8595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 N SHELBY ST",
            "city": "SALEM",
            "state": "IN",
            "postal_code": "471672304",
            "telephone_number": "812-883-8583",
            "fax_number": "812-883-8595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEN BROECK TENNESSEE PHYSICIANS GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-24",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A",
        "authorized_official_last_name": "HUTSON",
        "authorized_official_first_name": "KARISSA",
        "authorized_official_title_or_position": "BUSINESS OFFICE",
        "authorized_official_telephone_number": "931-319-4231"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2021; 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.