NPIMap

Organization Active NPI

Tennessee Physicians Alliance PC

Doing business as Cumberland Family Practice

  • Family Medicine Physician
  • Hendersonville, TN
National Provider Identifier
1467598870
Registry record updated Feb 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
TENNESSEE PHYSICIANS ALLIANCE PC
Doing business as
Cumberland Family Practice
Practice address
264 New Shackle Island Rd
Suite 107
Hendersonville, TN 37075-2481
Phone
(615) 824-4244
NPI assigned
Jan 30, 2007
Last updated
Feb 20, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2019

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

Authorized official

Name
Dr. Raul Couret, M.D.NPI 1306969696
Title
Physician/Owner
Phone
(615) 824-4244

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

264 New Shackle Island Rd
Suite 107
Hendersonville, TN 37075-2481

Mailing address

264 New Shackle Island Rd
Suite 107
Hendersonville, TN 37075-2481
Phone (615) 824-4244

Other identifiers 1

IdentifierTypeStateIssuer
Q026731MedicaidTN

Other names 1

  • Cumberland Family Practice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031216000148 TN Part B Supplier - Clinic/Group Practice 2264339597 Receives reassigned benefits from 14 practitioners
2 other NPIs on this enrollment
Practice locations: Hendersonville, TN

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D0307107Tennessee Physician Alliance264 New Shackle Island Rd Suite 107, Hendersonville, TN 37075Provider-performed microscopyFeb 17, 2027

National Provider Directory

National Provider Directory

Locations

264 New Shackle Island Rd
Ste 107
Hendersonvlle, TN 37075
Phone (615) 824-4244

353 New Shackle Island Rd
Ste 110A
Hendersonvlle, TN 37075
Phone (615) 264-4785

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GFDCBA

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550620800000",
    "number": "1467598870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "264 NEW SHACKLE ISLAND RD",
            "address_2": "SUITE 107",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "370752481",
            "telephone_number": "615-824-4244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "264 NEW SHACKLE ISLAND RD",
            "address_2": "SUITE 107",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "370752481",
            "telephone_number": "615-824-4244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TENNESSEE PHYSICIANS ALLIANCE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2019-02-20",
        "status": "A",
        "authorized_official_last_name": "COURET",
        "authorized_official_first_name": "RAUL",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "615-824-4244",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q026731",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cumberland Family Practice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cumberland Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hendersonville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.