NPIMap

Organization Active NPI

Hughston Clinic Southeast, PC

  • Nurse Practitioner
  • Nashville, TN
National Provider Identifier
1265044838
Registry record updated Aug 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
HUGHSTON CLINIC SOUTHEAST, PC
Practice address
3443 Dickerson Pike Ste 190
Nashville, TN 37207-2533
Phone
(615) 301-8269
Fax
(615) 712-9823
NPI assigned
Aug 17, 2020
Organization subpart
Yes
Parent organization
HUGHSTON CLINIC SOUTHEAST, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 17, 2020

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

Authorized official

Name
Amanda Fromkin
Title
Credentialing Manager
Phone
(706) 494-3071

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

3443 Dickerson Pike Ste 190
Nashville, TN 37207-2533

Mailing address

PO Box 370
Fortson, GA 31808-0370
Phone (706) 494-3008

Other identifiers 1

IdentifierTypeStateIssuer
7100579610MedicaidKY

National Provider Directory

National Provider Directory
Tax ID family
Hughston Clinic Southeast P9 organizations share this tax ID, including this one
Part of
Hughston Clinic Southeast P

Other organizations with this tax ID 8

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1597622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597622400000",
    "number": "1265044838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 370",
            "city": "FORTSON",
            "state": "GA",
            "postal_code": "318080370",
            "telephone_number": "706-494-3008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3443 DICKERSON PIKE STE 190",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372072533",
            "telephone_number": "615-301-8269",
            "fax_number": "615-712-9823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUGHSTON CLINIC SOUTHEAST, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HUGHSTON CLINIC SOUTHEAST, PC",
        "enumeration_date": "2020-08-17",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A",
        "authorized_official_last_name": "FROMKIN",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "706-494-3071"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100579610",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Aug 17, 2020; 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.