Middle Tennessee ASC, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

MIDDLE TENNESSEE ASC, LLC

Practice address

345 23Rd Ave North, Suite 401
Nashville, TN 37203

Phone

(818) 858-1080

NPI assigned

May 21, 2015

Organization subpart

Yes

Parent organization

FPG LABS LLCAs reported in NPPES

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

Authorized official

Name

Goldie Gupta

Title

Cfo

Phone

(630) 536-7738

Specialties & licenses 2

Addresses

Other names 1

• Ovation Fertility Doing business as

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

CLIA laboratory certificates

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

{
    "created_epoch": "1432166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631404800000",
    "number": "1487033593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15821 VENTURA BLVD, SUITE 625",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "91436",
            "telephone_number": "818-858-1080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 23RD AVE NORTH, SUITE 401",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "37203",
            "telephone_number": "818-858-1080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDDLE TENNESSEE ASC, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FPG LABS LLC",
        "enumeration_date": "2015-05-21",
        "last_updated": "2021-09-12",
        "certification_date": "2021-09-12",
        "status": "A",
        "authorized_official_last_name": "GUPTA",
        "authorized_official_first_name": "GOLDIE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "630-536-7738"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "TN",
            "license": "0000000173",
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ovation Fertility",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mid-State Physicians, LLC
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• Mid-Tenn Home Care LLC
• Mid-TN Supported Living, Inc.
• Middle Tennessee Clinical Evaluation Services PLLC
• Middle Tennessee Emergency Physicians PC
• Middle Tennessee Eyecare PLLC
• Middle Tennessee Hospitalist, PLC
• Middle Tennessee Imaging LLC

• Clinical Medical Laboratory in Nashville, TN
• Providers in Nashville, TN by specialty
• Clinical Medical Laboratory in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.