Vanderbilt Coffee Hospital, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

VANDERBILT COFFEE HOSPITAL, LLC

Practice address

1801 N Jackson St
Tullahoma, TN 37388-8259

Phone

(931) 393-3000

NPI assigned

Dec 11, 2020

Organization subpart

No

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

Authorized official

Name

Angela L Simmons

Title

VP - Finance

Phone

(615) 936-8875

Specialties & licenses 8

Addresses

Tax ID family

Vanderbilt Coffee Hospital LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Vanderbilt Coffee Hospital, LLC

  • General Acute Care Hospital
  • Tullahoma, TN
  • NPI 1831798719
  NPD tax ID
• Vanderbilt Coffee Hospital, LLC

  • Medicare Defined Swing Bed Hospital Unit
  • Tullahoma, TN
  • NPI 1891385316
  NPD tax ID

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

{
    "created_epoch": "1607644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629072000000",
    "number": "1417543646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 THOMPSON LN STE 30330",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372044701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 N JACKSON ST",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373888259",
            "telephone_number": "931-393-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANDERBILT COFFEE HOSPITAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-11",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-16",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "VP - FINANCE",
        "authorized_official_telephone_number": "615-936-8875"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pam Turner, B.S.
• Tara Beth Tye, NP-C
• Urgent Urgent America, LLC
• Francisco Vallejo, MD
• Terri Motley Vance, MMFT
• Vanderbilt Coffee Hospital, LLC
• Vanderbilt Coffee Hospital, LLC
• Vanderbilt Integrated Providers
• Vanderbilt Integrated Providers, LLC
• Vanderbilt Integrated Providers, LLC

• Internal Medicine Physician in Tullahoma, TN
• Providers in Tullahoma, TN by specialty
• Internal Medicine Physician in Tennessee

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