Northwest Tennessee Cardiology Clinic, P. C.

Primary specialty

SpecialistTaxonomy code 174400000X

License

17501 Issued in TN

Legal business name

NORTHWEST TENNESSEE CARDIOLOGY CLINIC, P. C.

Practice address

1304 Medical Park Cir
Union City, TN 38261-5876

Phone

(731) 886-1212

Fax

(731) 886-1220

NPI assigned

Nov 10, 2005

Last updated

Sep 30, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. James C Hall, M.D.NPI 1205884376

Title

Ceo

Phone

(731) 886-1212

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Practitioners 1

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.

• James C Hall, M.D.

  • Cardiovascular Disease Physician
  • Union City, TN
  • NPI 1205884376

  Specialist

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601424000000",
    "number": "1447231097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 MEDICAL PARK CIR",
            "city": "UNION CITY",
            "state": "TN",
            "postal_code": "382615876",
            "telephone_number": "731-886-1212",
            "fax_number": "731-886-1220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 MEDICAL PARK CIR",
            "city": "UNION CITY",
            "state": "TN",
            "postal_code": "382615876",
            "telephone_number": "731-886-1212",
            "fax_number": "731-886-1220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST TENNESSEE CARDIOLOGY CLINIC, P. C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-10",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "731-886-1212",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TN",
            "license": "17501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3024503",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "17501",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA #",
            "identifier": "44D0941660",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Union City, TN
• Providers in Union City, TN by specialty
• Specialist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2020; 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.