NPIMap

Organization Active NPI

Magnuson-Stimpson Medical Clinic

  • Family Medicine Physician
  • Shelbyville, TN
National Provider Identifier
1346397064
Registry record updated Jun 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD15929 Issued in TN
Legal business name
MAGNUSON-STIMPSON MEDICAL CLINIC
Doing business as
Magnuson-Stimpson Medical Clinic
Practice address
1701 N Main St
Suite D
Shelbyville, TN 37160-2303
Phone
(931) 685-4060
Fax
(931) 685-4062
NPI assigned
Jan 4, 2007
Last updated
Jun 1, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2010

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

Authorized official

Name
Dr. Carol L. Magnuson, M.D.NPI 1417928730
Title
General Partner
Phone
(931) 685-4060

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X MD15929 TN Primary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X MD19528 TN

Addresses

Primary practice location

1701 N Main St
Suite D
Shelbyville, TN 37160-2303

Mailing address

1701 N Main St
Suite D
Shelbyville, TN 37160-2303
Phone (931) 685-4060

Other identifiers 1

IdentifierTypeStateIssuer
3719310MedicaidTN

Other names 1

  • Magnuson-Stimpson Medical Clinic Doing business as

National Provider Directory

National Provider Directory

Locations

1701 N Main St
Ste D
Shelbyville, TN 37160
Phone (931) 685-4060

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275350400000",
    "number": "1346397064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 N MAIN ST",
            "address_2": "SUITE D",
            "city": "SHELBYVILLE",
            "state": "TN",
            "postal_code": "371602303",
            "telephone_number": "931-685-4060",
            "fax_number": "931-685-4062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 N MAIN ST",
            "address_2": "SUITE D",
            "city": "SHELBYVILLE",
            "state": "TN",
            "postal_code": "371602303",
            "telephone_number": "931-685-4060",
            "fax_number": "931-685-4062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNUSON-STIMPSON MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-04",
        "last_updated": "2010-06-01",
        "status": "A",
        "authorized_official_last_name": "MAGNUSON",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "GENERAL PARTNER",
        "authorized_official_telephone_number": "931-685-4060",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD15929",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "MD19528",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3719310",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Magnuson-Stimpson Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shelbyville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2010; 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.