NPIMap

Organization Active NPI

Northstar Medical Group LLC

  • Primary Care Clinic/Center
  • Clarksville, TN
National Provider Identifier
1295558484
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
NORTHSTAR MEDICAL GROUP LLC
Practice address
351 Dover Rd
Clarksville, TN 37042-4144
Phone
(931) 552-4495
Fax
(931) 552-0121
NPI assigned
Nov 5, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Authorized official

Name
Dr. William R Carney Jr., MD
Title
Chief Physician
Phone
(615) 891-0202

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

351 Dover Rd
Clarksville, TN 37042-4144

Mailing address

351 Dover Rd
Clarksville, TN 37042-4144
Phone (931) 552-4495

Other names 1

  • NorthStar Medical Group Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1730764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731974400000",
    "number": "1295558484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "351 DOVER RD",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370424144",
            "telephone_number": "931-552-4495",
            "fax_number": "931-552-0121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 DOVER RD",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370424144",
            "telephone_number": "931-552-4495",
            "fax_number": "931-552-0121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSTAR MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-05",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A",
        "authorized_official_last_name": "CARNEY",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CHIEF PHYSICIAN",
        "authorized_official_telephone_number": "615-891-0202",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NorthStar Medical Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NorthStar Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clarksville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; 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.