NPIMap

Organization Active NPI

Cumberland Imaging Associates, PC

  • Specialist
  • Cookeville, TN
National Provider Identifier
1437279262
Registry record updated Feb 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD31227 Issued in TN
Legal business name
CUMBERLAND IMAGING ASSOCIATES, PC
Practice address
142 W 5TH St
Cookeville, TN 38501-1760
Phone
(931) 528-2541
Fax
(931) 526-8814
NPI assigned
Mar 29, 2007
Last updated
Feb 15, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2022

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

Authorized official

Name
Jason L Hardin, MDNPI 1710183470
Title
President
Phone
(931) 528-2541

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD31227 TN Primary

Addresses

Primary practice location

142 W 5TH St
Cookeville, TN 38501-1760

Mailing address

PO Box 3262
Indianapolis, IN 46206-3262
Phone (931) 647-5034

Other identifiers 3

IdentifierTypeStateIssuer
DG0604OtherTNRAILROAD MEDICARE GROUP
3370031MedicaidTN
4151225OtherTNBLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, VA, SC, NC, GA, AL6 enrollments

Enrollment records 6

Enrollment IDStateProvider typePAC IDDetails
O20070723000898 TN Part B Supplier - Clinic/Group Practice 4284735051 Receives reassigned benefits from 4 practitioners
Practice locations: Livingston, TN; Cookeville, TN; Byrdstown, TN
O20200111000001 VA Part B Supplier - Clinic/Group Practice 4284735051 Receives reassigned benefits from 5 practitioners
Practice locations: Chesapeake, VA; Middleburg, VA; Glen Allen, VA; Falls Church, VA; Earlysville, VA
O20200111000012 SC Part B Supplier - Clinic/Group Practice 4284735051 Receives reassigned benefits from 1 practitioner
Practice locations: Sullivans Island, SC
O20200114000271 NC Part B Supplier - Clinic/Group Practice 4284735051 Receives reassigned benefits from 2 practitioners
Practice locations: Cary, NC; Fayetteville, NC; Greensboro, NC
O20200114000388 GA Part B Supplier - Clinic/Group Practice 4284735051 Receives reassigned benefits from 3 practitioners
Practice locations: Augusta, GA; Clayton, GA; Macon, GA
O20200114001684 AL Part B Supplier - Clinic/Group Practice 4284735051 Receives reassigned benefits from 1 practitioner
Practice locations: Madison, AL

National Provider Directory

National Provider Directory

Locations

315 Oak St
Livingston, TN 38570
Phone (931) 403-1197

Practitioners & affiliated clinicians

Practitioners 41

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.

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644883200000",
    "number": "1437279262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3262",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462063262",
            "telephone_number": "931-647-5034",
            "fax_number": "931-552-6663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 W 5TH ST",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385011760",
            "telephone_number": "931-528-2541",
            "fax_number": "931-526-8814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUMBERLAND IMAGING ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A",
        "authorized_official_last_name": "HARDIN",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "931-528-2541",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TN",
            "license": "MD31227",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP",
            "identifier": "DG0604",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3370031",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "4151225",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cookeville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 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.