Organization Active NPI

Due West Family Healthcare Inc

  • Family Medicine Physician
  • Madison, TN
National Provider Identifier
1457346702
Registry record updated Jan 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD20429 Issued in TN
Legal business name
DUE WEST FAMILY HEALTHCARE INC
Practice address
607 W Due West Ave Ste 102
Madison, TN 37115-4420
Phone
(615) 868-2229
Fax
(931) 393-2247
NPI assigned
Sep 13, 2005
Last updated
Jan 20, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2023

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

Authorized official

Name
Pat York
Title
Administrative Assistant
Phone
(615) 868-2229

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD20429 TN Primary

Addresses

Primary practice location

607 W Due West Ave Ste 102
Madison, TN 37115-4420

Mailing address

607 W Due West Ave Ste 102
Madison, TN 37115-4420
Phone (615) 868-2229

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040423000280 TN Part B Supplier - Clinic/Group Practice 4486640570 Receives reassigned benefits from 1 practitioner
Practice locations: Madison, TN

National Provider Directory

National Provider Directory

Locations

607 W Due West Ave
Ste 102
Madison, TN 37115
Phone (615) 868-2229

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674172800000",
    "number": "1457346702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 W DUE WEST AVE STE 102",
            "city": "MADISON",
            "state": "TN",
            "postal_code": "371154420",
            "telephone_number": "615-868-2229",
            "fax_number": "931-393-2432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 W DUE WEST AVE STE 102",
            "city": "MADISON",
            "state": "TN",
            "postal_code": "371154420",
            "telephone_number": "615-868-2229",
            "fax_number": "931-393-2247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUE WEST FAMILY HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-13",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A",
        "authorized_official_last_name": "YORK",
        "authorized_official_first_name": "PAT",
        "authorized_official_title_or_position": "ADMINISTRATIVE ASSISTANT",
        "authorized_official_telephone_number": "615-868-2229"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD20429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2023; 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.