NPIMap

Organization Active NPI

Family Health Group Inc

  • Family Medicine Physician
  • Waynesboro, TN
National Provider Identifier
1336199041
Registry record updated Jun 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FAMILY HEALTH GROUP INC
Practice address
107 J V Manguat Dr
Waynesboro, TN 38485-2440
Phone
(931) 722-2800
Fax
(931) 722-9627
NPI assigned
May 11, 2006
Last updated
Jun 10, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2009

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

Authorized official

Name
Mr. Harold E Preston
Title
Ceo
Phone
(931) 540-4255

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Family Medicine Physician 207Q00000X Primary
Internal Medicine Physician 207R00000X
General Practice Physician 208D00000X

Addresses

Primary practice location

107 J V Manguat Dr
Waynesboro, TN 38485-2440

Mailing address

854 W James Campbell Blvd
Suite 303
Columbia, TN 38401-4659
Phone (931) 540-4255

Other identifiers 1

IdentifierTypeStateIssuer
3710086MedicaidTN

National Provider Directory

National Provider Directory
Tax ID family
Maury Regional Medical Grou12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244592000000",
    "number": "1336199041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "854 W JAMES CAMPBELL BLVD",
            "address_2": "SUITE 303",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384014659",
            "telephone_number": "931-540-4255",
            "fax_number": "931-490-4654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 J V MANGUAT DR",
            "city": "WAYNESBORO",
            "state": "TN",
            "postal_code": "384852440",
            "telephone_number": "931-722-2800",
            "fax_number": "931-722-9627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTH GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-11",
        "last_updated": "2009-06-10",
        "status": "A",
        "authorized_official_last_name": "PRESTON",
        "authorized_official_first_name": "HAROLD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "931-540-4255",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3710086",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waynesboro, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2009; 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.