NPIMap

Organization Active NPI

Amg-Southern Tennessee, LLC

  • Durable Medical Equipment & Medical Supplies
  • Winchester, TN
National Provider Identifier
1467769331
Registry record updated Nov 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
AMG-SOUTHERN TENNESSEE, LLC
Practice address
183 Hospital Rd
Suite B
Winchester, TN 37398-2470
Phone
(931) 962-2272
Fax
(931) 962-8588
NPI assigned
Sep 13, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2021

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

Authorized official

Name
Kathy Teague
Title
Avp, Secretary
Phone
(615) 920-7000

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X
Orthopaedic Surgery of the Spine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XS0117X
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

183 Hospital Rd
Suite B
Winchester, TN 37398-2470

Mailing address

330 Seven Springs Way
Brentwood, TN 37027-5098
Phone (615) 920-7000

Other identifiers 1

IdentifierTypeStateIssuer
1521108MedicaidTN

Other names 1

  • Southern Tennessee Orthopedic and Spine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041013001206 TN Part B Supplier - Clinic/Group Practice 5991765943 Receives reassigned benefits from 112 practitioners
41 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Tullahoma, TN; Winchester, TN; Decherd, TN; Estill Springs, TN; Fayetteville, TN; Huntland, TN; Lawrenceburg, TN; Lynchburg, TN…

Other NPIs on the same Medicare enrollment 41

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

View all 41

National Provider Directory

National Provider Directory

Locations

2260 Thornton Taylor Pkwy
Ste B
Fayetteville, TN 37334
Phone (931) 438-4499

NPI Registry JSON

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

{
    "created_epoch": "1284336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637625600000",
    "number": "1467769331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 SEVEN SPRINGS WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275098",
            "telephone_number": "615-920-7000",
            "fax_number": "931-962-8588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "183 HOSPITAL RD",
            "address_2": "SUITE B",
            "city": "WINCHESTER",
            "state": "TN",
            "postal_code": "373982470",
            "telephone_number": "931-962-2272",
            "fax_number": "931-962-8588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMG-SOUTHERN TENNESSEE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-13",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A",
        "authorized_official_last_name": "TEAGUE",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "AVP, SECRETARY",
        "authorized_official_telephone_number": "615-920-7000"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1521108",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern Tennessee Orthopedic and Spine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southern Tennessee Orthopedic and Spine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Winchester, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2021; 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.