Organization Active NPI

Knolls Place Medical Clinic LLC

  • Clinic/Center
  • Nashville, TN
National Provider Identifier
1508130428
Registry record updated Feb 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
45100 Issued in TN
Legal business name
KNOLLS PLACE MEDICAL CLINIC LLC
Practice address
10 Knolls PL
Nashville, TN 37211-7410
Phone
(615) 457-1265
Fax
(615) 457-1326
NPI assigned
Feb 24, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2012

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

Authorized official

Name
Dr. Songmin Cai, M.D.NPI 1063659209
Title
Director
Phone
(615) 457-1265

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 45100 TN Primary

Addresses

Primary practice location

10 Knolls PL
Nashville, TN 37211-7410

Mailing address

10 Knolls PL
Nashville, TN 37211-7410
Phone (615) 457-1265

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120306000205 TN Part B Supplier - Clinic/Group Practice 2961661236 Receives reassigned benefits from 2 practitioners
Practice locations: Nashville, TN

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
44D2037155Knolls Place Medical Clinic10 Knolls Place, Nashville, TN 37211Certificate of waiverSep 3, 2026

National Provider Directory

National Provider Directory

Locations

10 Knolls Pl
Nashville, TN 37211
Phone (615) 457-1265

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1330041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330041600000",
    "number": "1508130428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 KNOLLS PL",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372117410",
            "telephone_number": "615-457-1265",
            "fax_number": "615-457-1326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 KNOLLS PL",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372117410",
            "telephone_number": "615-457-1265",
            "fax_number": "615-457-1326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KNOLLS PLACE MEDICAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-24",
        "last_updated": "2012-02-24",
        "status": "A",
        "authorized_official_last_name": "CAI",
        "authorized_official_first_name": "SONGMIN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "615-457-1265",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "TN",
            "license": "45100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2012; 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.