NPIMap

Organization Active NPI

Skyline Medical Group LLC

  • Specialist
  • Nashville, TN
National Provider Identifier
1336154202
Registry record updated Oct 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
SKYLINE MEDICAL GROUP LLC
Practice address
3443 Dickerson Pike
Suite G-30
Nashville, TN 37207-2519
Phone
(615) 234-6390
Fax
(615) 234-6393
NPI assigned
Jul 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2025

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

Authorized official

Name
Jeff Rydburg
Title
Vice President
Phone
(615) 373-7415

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary
Oral & Maxillofacial Surgery (D.M.D.)Group: 193200000X MULTI-SPECIALTY GROUP 204E00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

3443 Dickerson Pike
Suite G-30
Nashville, TN 37207-2519

Mailing address

3443 Dickerson Pike
Suite G-30
Nashville, TN 37207-2519
Phone (615) 234-6390

Other identifiers 1

IdentifierTypeStateIssuer
3735178MedicaidTN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061212000636 TN Part B Supplier - Clinic/Group Practice 6709885189 Receives reassigned benefits from 46 practitioners
Practice locations: Nashville, TN; White House, TN; Hendersonville, TN; Goodlettsville, TN

National Provider Directory

National Provider Directory

Locations

201 Uffelman Dr
Clarksville, TN 37043
Phone (931) 645-5440

1760 Madison St
Clarksville, TN 37043
Phone (931) 552-6622

304 Northcreek Blvd
Goodlettsville, TN 37072
Phone (615) 859-8488

401 Windsor Green Ct
Goodlettsville, TN 37072

1424 W Baddour Pkwy
Ste D
Lebanon, TN 37087
Phone (615) 443-0882

846 E Meade Ave
Madison, TN 37115
Phone (615) 612-0202

1639 Medical Center Pkwy
Ste 203
Murfreesboro, TN 37129
Phone (615) 895-8383

3443 Dickerson Pike
Ste 440
Nashville, TN 37207
Phone (615) 712-7261

545 Mainstream Dr
Ste 100
Nashville, TN 37228
Phone (615) 259-2772

2100 Park Plaza Dr
Springfield, TN 37172
Phone (615) 384-0687

Practitioners & affiliated clinicians

Practitioners 49

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

View all 49

NPI Registry JSON

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761868800000",
    "number": "1336154202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3443 DICKERSON PIKE",
            "address_2": "SUITE G-30",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372072519",
            "telephone_number": "615-234-6390",
            "fax_number": "615-234-6393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3443 DICKERSON PIKE",
            "address_2": "SUITE G-30",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372072519",
            "telephone_number": "615-234-6390",
            "fax_number": "615-234-6393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKYLINE MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-29",
        "last_updated": "2025-10-31",
        "certification_date": "2025-10-31",
        "status": "A",
        "authorized_official_last_name": "RYDBURG",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "615-373-7415"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3735178",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2025; 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.