Organization Active NPI

Bradlake Medical Center, Inc

  • Internal Medicine Physician
  • Nashville, TN
National Provider Identifier
1336407147
Registry record updated Mar 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD0000014656 Issued in TN
Legal business name
BRADLAKE MEDICAL CENTER, INC
Practice address
500 Mapleleaf Drive
Suite 200
Nashville, TN 37210
Phone
(615) 232-7162
Fax
(615) 232-7308
NPI assigned
Apr 30, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2013

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

Authorized official

Name
Ms. Chinwe C Umeh
Title
Manager
Phone
(615) 232-7162

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X MD0000014656 TN Primary
Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0000X
Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0000X MD0000014656 TN

Addresses

Primary practice location

500 Mapleleaf Drive
Suite 200
Nashville, TN 37210

Mailing address

P.O Box 148576
Nashville, TN 37214
Phone (615) 232-7162

Other identifiers 1

IdentifierTypeStateIssuer
1528386MedicaidTN

National Provider Directory

National Provider Directory

Locations

500 Mapleleaf Dr
Ste 200
Nashville, TN 37210
Phone (615) 232-7162

131 Donelson Pike
Nashville, TN 37214
Phone (615) 232-7162

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1335744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364342400000",
    "number": "1336407147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O BOX 148576",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "37214",
            "telephone_number": "615-232-7162",
            "fax_number": "615-232-7308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 MAPLELEAF DRIVE",
            "address_2": "SUITE 200",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "37210",
            "telephone_number": "615-232-7162",
            "fax_number": "615-232-7308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADLAKE MEDICAL CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-30",
        "last_updated": "2013-03-27",
        "status": "A",
        "authorized_official_last_name": "UMEH",
        "authorized_official_first_name": "CHINWE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "615-232-7162",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD0000014656",
            "primary": true
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "TN",
            "license": "MD0000014656",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1528386",
            "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 Mar 27, 2013; 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.