Tenn SM LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

00000000199 Issued in TN

Legal business name

TENN SM LLC

Practice address

5002 Crossings Cir
Ste 110
Mount Juliet, TN 37122-8471

Phone

(615) 553-9100

Fax

(615) 553-9109

NPI assigned

Jul 29, 2008

Organization subpart

No

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

Authorized official

Name

Kristen O'Connor

Title

Authorized Official

Phone

(615) 376-7315

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Listed as

Providence Surgery CenterCCN 44C0001169

Medicare certification status

ActiveFrom the Provider of Services file

Tax ID family

Tenn SM LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Tenn SM, LLC

  • Specialist
  • Smyrna, TN
  • NPI 1780866483
  NPD tax ID
• Tenn SM, LLC

  • Specialist
  • Lebanon, TN
  • NPI 1871775577
  NPD tax ID

Member of 3

Organizations this organization is a member of, according to the National Provider Directory.

• Saint Thomas Health

  • Community/Retail Pharmacy
  • Nashville, TN
  • NPI 1861806911

  Member Of

  NPD member
• Baylor University Medical Center

  • General Acute Care Hospital
  • Dallas, TX
  • NPI 1447250253

  Member Of

  NPD member
• VHS San Antonio Partners LLC

  • Psychiatric Hospital Unit
  • San Antonio, TX
  • NPI 1487633509

  Member Of

  NPD member

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gregory G White, MD

  • Orthopaedic Surgery Physician
  • New Smyrna Beach, FL
  • NPI 1851368377
  NPD (past)

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

{
    "created_epoch": "1217289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725580800000",
    "number": "1235395385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5002 CROSSINGS CIR",
            "address_2": "STE 110",
            "city": "MOUNT JULIET",
            "state": "TN",
            "postal_code": "371228471",
            "telephone_number": "615-553-9100",
            "fax_number": "615-553-9109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5002 CROSSINGS CIR",
            "address_2": "STE 110",
            "city": "MOUNT JULIET",
            "state": "TN",
            "postal_code": "371228471",
            "telephone_number": "615-553-9100",
            "fax_number": "615-553-9109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TENN SM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-29",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A",
        "authorized_official_last_name": "O'CONNOR",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "615-376-7315"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "TN",
            "license": "00000000199",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MCR",
            "identifier": "DC6548",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/gateway/documentsubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lavanya Tammareddi, O.D.
• Allen Ervin Tate, PA
• Jennifer Tate
• Angelina Taylor Cortez, RN
• Amy E Taylor, APRN
• Tenn SM, LLC
• Tennessee CVS Pharmacy LLC
• Tennessee Dental Professionals PC
• Tennessee Dental Professionals, PC
• Tennessee Imaging Alliance LLC

• Ambulatory Surgical Clinic/Center in Mount Juliet, TN
• Providers in Mount Juliet, TN by specialty
• Ambulatory Surgical Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.