NGX Tennessee PLLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

NGX TENNESSEE PLLC

Practice address

490 Long Hollow Pike
Goodlettsville, TN 37072-3480

Phone

(629) 600-4200

Fax

(629) 600-4201

NPI assigned

Sep 13, 2023

Organization subpart

No

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

Authorized official

Name

Richard Graciano

Title

Patient Service Center Manager

Phone

(915) 261-9418

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1694563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694563200000",
    "number": "1437936499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "490 LONG HOLLOW PIKE",
            "city": "GOODLETTSVILLE",
            "state": "TN",
            "postal_code": "370723480",
            "telephone_number": "629-600-4200",
            "fax_number": "629-600-4201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 LONG HOLLOW PIKE",
            "city": "GOODLETTSVILLE",
            "state": "TN",
            "postal_code": "370723480",
            "telephone_number": "629-600-4200",
            "fax_number": "629-600-4201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NGX TENNESSEE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-13",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A",
        "authorized_official_last_name": "GRACIANO",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "PATIENT SERVICE CENTER MANAGER",
        "authorized_official_telephone_number": "915-261-9418"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Medicine & Rehabilitation Physician in Goodlettsville, TN
• Providers in Goodlettsville, TN by specialty
• Physical Medicine & Rehabilitation Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2023; 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.