NPIMap

Organization Active NPI

Family Health Care of Hendersonville, PLLC

  • Family Medicine Physician
  • Hendersonville, TN
National Provider Identifier
1326073396
Registry record updated Oct 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
16926 Issued in TN
Legal business name
FAMILY HEALTH CARE OF HENDERSONVILLE, PLLC
Practice address
211 Indian Lake Blvd Ste a
Hendersonville, TN 37075-6442
Phone
(615) 826-3100
Fax
(615) 447-1060
NPI assigned
Jul 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2023

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

Authorized official

Name
Dr. Anthony V Dallas Jr., M.D.NPI 1861437063
Title
Partner
Phone
(615) 826-3100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 16926 TN Primary

Addresses

Primary practice location

211 Indian Lake Blvd Ste a
Hendersonville, TN 37075-6442

Mailing address

211 Indian Lake Blvd Ste a
Hendersonville, TN 37075-6442
Phone (615) 826-3100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031216000148 TN Part B Supplier - Clinic/Group Practice 2264339597 Receives reassigned benefits from 14 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hendersonville, TN
O20040116000305 TN Part B Supplier - Clinic/Group Practice 1850292426 Receives reassigned benefits from 8 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hendersonville, TN

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

211 Indian Lake Blvd
Hendersonville, TN 37075
Phone (615) 826-3100

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3880/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697760000000",
    "number": "1326073396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 INDIAN LAKE BLVD STE A",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "370756442",
            "telephone_number": "615-826-3100",
            "fax_number": "615-447-1060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 INDIAN LAKE BLVD STE A",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "370756442",
            "telephone_number": "615-826-3100",
            "fax_number": "615-447-1060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTH CARE OF HENDERSONVILLE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A",
        "authorized_official_last_name": "DALLAS",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "615-826-3100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "16926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hendersonville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2023; 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.