Tullahoma Orthopaedics & Sports Medicine PLLC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

TULLAHOMA ORTHOPAEDICS & SPORTS MEDICINE PLLC

Practice address

1816 N Washington St
Suite 100
Tullahoma, TN 37388-2222

Phone

(931) 455-8676

Fax

(931) 455-9983

NPI assigned

Sep 14, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Gary R Stevens, DO

Title

Partner

Phone

(931) 455-8676

Specialties & licenses 3

Addresses

Other identifiers 4

Locations

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

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302652800000",
    "number": "1306831417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1816 N WASHINGTON ST",
            "address_2": "SUITE 100",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373882222",
            "telephone_number": "931-455-8676",
            "fax_number": "931-455-9983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1816 N WASHINGTON ST",
            "address_2": "SUITE 100",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373882222",
            "telephone_number": "931-455-8676",
            "fax_number": "931-455-9983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TULLAHOMA ORTHOPAEDICS & SPORTS MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-14",
        "last_updated": "2011-04-13",
        "status": "A",
        "authorized_official_last_name": "STEVENS",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "931-455-8676",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "10070483",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3713655",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR WORKER COMP",
            "identifier": "166220000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "3093519",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tullahoma Immediate Care PC
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• Tullahoma Internal Medicine, PLLC
• Tullahoma Neurodiagnostic Clinic PC
• Tullahoma Oral Surgery, P.C.
• Tullahoma Pediatric Therapy, LLC
• Tullahoma Pediatrics PLLC
• Tullahoma Physicians Group, PLLC
• Tullahoma Sleep Disorder Center
• Tullahoma Spine & Wellness

• Orthopaedic Surgery Physician in Tullahoma, TN
• Providers in Tullahoma, TN by specialty
• Orthopaedic Surgery Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2011; 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.