360 Integrated Care PC

Primary specialty

Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X

Legal business name

360 INTEGRATED CARE PC

Practice address

1210 Briarville Rd.
BLDG B
Madison, TN 37115

Phone

(615) 868-8612

Fax

(615) 860-4510

NPI assigned

Nov 16, 2021

Last updated

Nov 16, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Thomas B Miller

Title

President/Owner

Phone

(615) 868-8612

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1637020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637020800000",
    "number": "1366108102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 BRIARVILLE RD.",
            "address_2": "BLDG B",
            "city": "MADISON",
            "state": "TN",
            "postal_code": "37115",
            "telephone_number": "615-868-8612",
            "fax_number": "615-860-4510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 BRIARVILLE RD.",
            "address_2": "BLDG B",
            "city": "MADISON",
            "state": "TN",
            "postal_code": "37115",
            "telephone_number": "615-868-8612",
            "fax_number": "615-860-4510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "360 INTEGRATED CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-16",
        "last_updated": "2021-11-16",
        "certification_date": "2021-11-16",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "615-868-8612"
    },
    "taxonomies": [
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction Medicine (Internal Medicine) Physician in Madison, TN
• Providers in Madison, TN by specialty
• Addiction Medicine (Internal Medicine) Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2021; 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.