Individual provider Active NPI

Jack Hua

  • Diagnostic Radiology Physician
  • Murfreesboro, TN
National Provider Identifier
1437686201
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD67813 Issued in TN
Practice address
1272 Garrison Dr
Murfreesboro, TN 37129-2598
Phone
(615) 893-4480
NPI assigned
May 11, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 010029533 LA
Diagnostic Radiology Physician 2085R0202X MD67813 TN Primary
Diagnostic Radiology Physician 2085R0202X 4301506546 MI

Addresses

Primary practice location

1272 Garrison Dr
Murfreesboro, TN 37129-2598

Mailing address

1272 Garrison Dr
Murfreesboro, TN 37129-2598
Phone (615) 893-4480

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231114000739 TN Practitioner - Diagnostic Radiology 5597149161 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Tulane University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Murfreesboro Medical Clinic, P.a.Group PAC ID 4789589227, 176 clinicians

Practice addresses (Care Compare)

1272 Garrison Dr
Murfreesboro, TN 37129-2598
Phone (615) 867-7925

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MD67813TNMDDiagnostic Radiology Physician
010029533LAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Murfreesboro Medical Clinic, P.a. Current Accepting new patients
Regents of the University of Michigan Current Accepting new patients
Metropolitan Hospital Past Accepting new patients
Metropolitan Hospital Past Accepting new patients

Locations

3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229

1272 Garrison Dr
Murfreesboro, TN 37129
Phone (615) 867-7925

Interoperability endpoints

  • Direct secure messaging: jackhua@mmcsc.allscriptsdirect.net

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1437686201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1272 GARRISON DR",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371292598",
            "telephone_number": "615-893-4480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1272 GARRISON DR",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371292598",
            "telephone_number": "615-893-4480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUA",
        "first_name": "JACK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-11",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "LA",
            "license": "010029533",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TN",
            "license": "MD67813",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301506546",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murfreesboro, TN

Sources for this page

Verify at the official NPI Registry.