NPIMap

Organization Active NPI

Privia Medical Group Tennessee LLC

Doing business as Sports Ortho Urgent Care

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Murfreesboro, TN
National Provider Identifier
1275290298
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
820 N Thompson LN Ste 1H
Murfreesboro, TN 37129-4340
Phone
(571) 982-6636
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 Primary

Addresses

Primary practice location

820 N Thompson LN Ste 1H
Murfreesboro, TN 37129-4340

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
Tax ID family
Privia Medical Group Tennessee LLC12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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": "1637712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657670400000",
    "number": "1275290298",
    "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": "820 N THOMPSON LN STE 1H",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371294340",
            "telephone_number": "571-982-6636"
        }
    ],
    "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": null,
            "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 Murfreesboro, 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.