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Organization Active NPI

Privia Medical Group Tennessee LLC

Doing business as Sports Ortho Urgent Care

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Nashville, TN
National Provider Identifier
1215694229
Registry record updated Jul 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
Legal business name
PRIVIA MEDICAL GROUP TENNESSEE LLC
Doing business as
Sports Ortho Urgent Care
Practice address
1214 Gallatin Ave Ste 105
Nashville, TN 37206-3270
Phone
(571) 982-8850
NPI assigned
Nov 24, 2021
Last updated
Jul 13, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2022

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

Authorized official

Name
Mary Roller
Title
Associate Director/Enrollment
Phone
(770) 312-5226

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X NU Primary

Addresses

Primary practice location

1214 Gallatin Ave Ste 105
Nashville, TN 37206-3270

Mailing address

950 N Glebe Rd Ste 700
Arlington, VA 22203-4173
Phone (571) 982-6636

Other names 1

  • Sports Ortho Urgent Care Doing business as

National Provider Directory

National Provider Directory

Locations

1492 Tiny Town Rd
Ste A2
Clarksville, TN 37042

55 Mouse Creek Rd NW
Cleveland, TN 37312
Phone (423) 478-8989

753 Humble Dr
Ste B
Cookeville, TN 38501
Phone (931) 520-1800

397 Wallace Rd
Ste 309
Nashville, TN 37211
Phone (615) 781-4100

127 Enon Springs Rd E
Smyrna, TN 37167
Phone (615) 462-7316

496 Northcrest Dr
Ste 496
Springfield, TN 37172
Phone (615) 380-8251

Practitioners & affiliated clinicians

Practitioners 211

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.

View all 211

NPI Registry JSON

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

{
    "created_epoch": "1637712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657670400000",
    "number": "1215694229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 N GLEBE RD STE 700",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222034173",
            "telephone_number": "571-982-6636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1214 GALLATIN AVE STE 105",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372063270",
            "telephone_number": "571-982-8850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIVIA MEDICAL GROUP TENNESSEE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-24",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A",
        "authorized_official_last_name": "ROLLER",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "ASSOCIATE DIRECTOR/ENROLLMENT",
        "authorized_official_telephone_number": "770-312-5226"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sports Ortho Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sports Ortho Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Nashville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2022; 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.