Gethsemane Cardiovascular Clinic PLLC

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

38872 Issued in TN

Legal business name

GETHSEMANE CARDIOVASCULAR CLINIC PLLC

Practice address

1602 W Northfield Blvd
Suite 511
Murfreesboro, TN 37129-6057

Phone

(615) 494-1255

NPI assigned

Jun 25, 2010

Organization subpart

No

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

Authorized official

Name

Mrs. Vanessa Jackson

Title

Admin

Phone

(615) 494-1255

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Practitioners 3

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

• Paul A Jackson, M.D.

  • Cardiovascular Disease Physician
  • Murfreesboro, TN
  • NPI 1093738536
  Medicare reassignment NPD
• Deborah Carroll Odom, RN, ACNP

  • Acute Care Nurse Practitioner
  • Murfreesboro, TN
  • NPI 1437472115
  Medicare reassignment NPD
• Kristyn Lee Gordon, APRN

  • Adult Health Nurse Practitioner
  • Lexington, KY
  • NPI 1801023718
  NPD (past)

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

{
    "created_epoch": "1277424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277424000000",
    "number": "1356652200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 W NORTHFIELD BLVD",
            "address_2": "SUITE 511",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371296057",
            "telephone_number": "615-494-1255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 W NORTHFIELD BLVD",
            "address_2": "SUITE 511",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371296057",
            "telephone_number": "615-494-1255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GETHSEMANE CARDIOVASCULAR CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-25",
        "last_updated": "2010-06-25",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "VANESSA",
        "authorized_official_title_or_position": "ADMIN",
        "authorized_official_telephone_number": "615-494-1255",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TN",
            "license": "38872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennie Gerardo, LPC
• James L. Gerfin, MD
• Mistie Dawn Germek, PH.D.
• Justin B Gerth, MD
• Gethsemane Cardiovascular Clinic
• Nashwa Esmat Ghattas
• Kayley Ghazi
• Merna Abdelmalak Ghobrial, OD
• Remon Talaat Ghobrial
• Deanna Gholson

• Cardiovascular Disease Physician in Murfreesboro, TN
• Providers in Murfreesboro, TN by specialty
• Cardiovascular Disease Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2010; 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.