Columbia Multi Specialty Clinic PLLC

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

TN LIC # 31656 Issued in TN

Legal business name

COLUMBIA MULTI SPECIALTY CLINIC PLLC

Practice address

1394 Hatcher LN
Same
Columbia, TN 38401-3586

Phone

(931) 388-9388

Fax

(931) 388-9808

NPI assigned

Nov 30, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Indu Bali, MD

Title

Ceo

Phone

(931) 388-9388

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• CMSMC Other name

Locations

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1497822548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1394 HATCHER LN",
            "address_2": "SUITE A",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384013586",
            "telephone_number": "931-388-9388",
            "fax_number": "931-388-9808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1394 HATCHER LN",
            "address_2": "SAME",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384013586",
            "telephone_number": "931-388-9388",
            "fax_number": "931-388-9808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIA MULTI SPECIALTY CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "BALI",
        "authorized_official_first_name": "INDU",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "931-388-9388",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": "TN",
            "license": "TN LIC # 31656",
            "primary": true
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4059771",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CMSMC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Adult Medicine Physician in Columbia, TN
• Providers in Columbia, TN by specialty
• Adult Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.