Individual provider Active NPI

Luis P Calderon, ACNP, BC

  • Acute Care Nurse Practitioner
  • Murfreesboro, TN
National Provider Identifier
1295901205
Registry record updated Jan 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
RN0000120779 Issued in TN
Practice address
1272 Garrison Dr
Murfreesboro, TN 37129-2598
Phone
(615) 867-8200
Fax
(615) 867-8039
NPI assigned
Apr 30, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X RN0000120779 TN Primary

Addresses

Primary practice location

1272 Garrison Dr
Murfreesboro, TN 37129-2598

Mailing address

1272 Garrison Dr
Murfreesboro, TN 37129-2598
Phone (615) 867-8200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040525001022 TN Practitioner - Nurse Practitioner 7810978046 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
7792TNMDClinical Social Worker
RN0000120779TNMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Murfreesboro Medical Clinic, P.a. Current Accepting new patients
Southern Anesthesia Consultants LLC PastSince Oct 1, 2017 Accepting new patients

Locations

1272 Garrison Dr
Murfreesboro, TN 37129
Phone (615) 867-7925

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1209513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420675200000",
    "number": "1295901205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1272 GARRISON DR",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371292598",
            "telephone_number": "615-867-8200",
            "fax_number": "615-867-8039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1272 GARRISON DR",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371292598",
            "telephone_number": "615-867-8200",
            "fax_number": "615-867-8039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDERON",
        "first_name": "LUIS",
        "middle_name": "P",
        "credential": "ACNP, BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-30",
        "last_updated": "2015-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TN",
            "license": "RN0000120779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murfreesboro, TN

Sources for this page

Verify at the official NPI Registry.