Active NPI
Jack Hua
- Diagnostic Radiology Physician
- Murfreesboro, TN
National Provider Identifier
1437686201
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- MD67813
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| MD67813 | TN | MD | Diagnostic Radiology Physician |
| 010029533 | LA | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New 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
- 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.
-
- Specialist
- Murfreesboro, TN
- NPI 1487604609
-
- Specialist
- Murfreesboro, TN
- NPI 1639299803
-
- Internal Medicine Physician
- Ann Arbor, MI
- NPI 1205868353
-
- Family Medicine Physician
- Wyoming, MI
- NPI 1114947538
-
- Anatomic Pathology & Clinical Pathology Physician
- Wyoming, MI
- NPI 1336182542
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.