Old Hickory Psychiatric Assn PLLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

35261 Issued in TN

Legal business name

OLD HICKORY PSYCHIATRIC ASSN PLLC

Practice address

706 Cadet CT
Lebanon, TN 37087-2649

Phone

(615) 206-9111

Fax

(615) 789-8315

NPI assigned

Sep 27, 2006

Organization subpart

No

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

Authorized official

Name

Don J Elazar, MDNPI 1730370610

Title

Chief Manager

Phone

(615) 206-9111

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Practitioners 1

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

• Don J Elazar, MD

  • Psychiatry Physician
  • Gallatin, TN
  • NPI 1730370610
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669852800000",
    "number": "1376634907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "695 NASHVILLE PIKE 313",
            "city": "GALLATIN",
            "state": "TN",
            "postal_code": "37066",
            "telephone_number": "615-206-9111",
            "fax_number": "615-206-9212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 CADET CT",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370872649",
            "telephone_number": "615-206-9111",
            "fax_number": "615-789-8315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLD HICKORY PSYCHIATRIC ASSN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A",
        "authorized_official_last_name": "ELAZAR",
        "authorized_official_first_name": "DON",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIEF MANAGER",
        "authorized_official_telephone_number": "615-206-9111",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TN",
            "license": "35261",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3879766",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Michael O'Brien, DPT
• Valerie O'Connell, PA
• Jennifer Marie O'Donnell, MD
• Audrey Ann O'Neill, PA-C
• Emily Victoria O'Neill
• Karen L Oldham, MD
• Oleksandr Osipchuk MD PHD Psychiatric Services LLC
• Andre C Olivier, MD
• Omni Community Health
• On-Call Med Infusion Inc

• Psychiatry Physician in Lebanon, TN
• Providers in Lebanon, TN by specialty
• Psychiatry Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2022; 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.