NPIMap

Organization Active NPI

Tennessee Physician Services, LLC

Doing business as United Telehealth Services

  • Neonatal-Perinatal Medicine Physician
  • Statesboro, GA
National Provider Identifier
1316206535
Registry record updated Feb 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
Legal business name
TENNESSEE PHYSICIAN SERVICES, LLC
Doing business as
United Telehealth Services
Practice address
1499 Fair Rd
Statesboro, GA 30458-1683
Phone
(800) 301-6254
Fax
(888) 972-5992
NPI assigned
May 8, 2012
Last updated
Feb 14, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2024

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

Authorized official

Name
Deb Gott
Title
Director of Program Management
Phone
(800) 301-6254

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X
Neonatal Nurse Practitioner 363LN0000X
Pediatric Nurse Practitioner 363LP0200X
Maternal & Fetal Medicine Physician 207VM0101X
Neonatal-Perinatal Medicine Physician 2080N0001X Primary

Addresses

Primary practice location

1499 Fair Rd
Statesboro, GA 30458-1683

Mailing address

5050 Thoroughbred Lane
Suite C
Brentwood, TN 37027
Phone (800) 301-6254

Other practice location 1

3651 Wheeler Rd
Augusta, GA 30909-6426
Phone (800) 301-6254

Other practice location 2

5050 Thoroughbred Ln Ste C
Brentwood, TN 37027-4234
Phone (800) 301-6254 ext. 4

Other practice location 3

350 Hospital Dr
Macon, GA 31217-3838
Phone (800) 301-6254 ext. 1

Other practice location 4

185 Hospital Rd
Winchester, TN 37398-2404
Phone (800) 301-6254

Other identifiers 1

IdentifierTypeStateIssuer
003181293AMedicaidGA

Other names 1

  • United Telehealth Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120613000518 TN Part B Supplier - Clinic/Group Practice 0840454344 Receives reassigned benefits from 1 practitioner
Practice locations: Brentwood, TN; Cleveland, TN

National Provider Directory

National Provider Directory

Locations

3624 J Dewey Gray Cir
Augusta, GA 30909
Phone (706) 651-6754

5050 Thoroughbred Ln
Ste C
Brentwood, TN 37027
Phone (615) 982-2202

102 Woodmont Blvd
Ste 200
Nashville, TN 37205
Phone (615) 293-7462

185 Hospital Rd
Winchester, TN 37398
Phone (931) 962-4061

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1336435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707868800000",
    "number": "1316206535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5050 THOROUGHBRED LANE",
            "address_2": "SUITE C",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "37027",
            "telephone_number": "800-301-6254",
            "fax_number": "888-972-5992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1499 FAIR RD",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304581683",
            "telephone_number": "800-301-6254",
            "fax_number": "888-972-5992"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3651 Wheeler Rd",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309096426",
            "country_code": "US",
            "telephone_number": "800-301-6254",
            "fax_number": "888-972-5992",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5050 Thoroughbred Ln Ste C",
            "address_purpose": "LOCATION",
            "city": "Brentwood",
            "state": "TN",
            "postal_code": "370274234",
            "country_code": "US",
            "telephone_number": "800-301-6254 x4",
            "fax_number": "888-972-5992",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "350 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Macon",
            "state": "GA",
            "postal_code": "312173838",
            "country_code": "US",
            "telephone_number": "800-301-6254 x1",
            "fax_number": "888-972-5992",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "185 Hospital Rd",
            "address_purpose": "LOCATION",
            "city": "Winchester",
            "state": "TN",
            "postal_code": "373982404",
            "country_code": "US",
            "telephone_number": "800-301-6254",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TENNESSEE PHYSICIAN SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-08",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A",
        "authorized_official_last_name": "GOTT",
        "authorized_official_first_name": "DEB",
        "authorized_official_title_or_position": "DIRECTOR OF PROGRAM MANAGEMENT",
        "authorized_official_telephone_number": "800-301-6254"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003181293A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "United Telehealth Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Statesboro, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.