Active NPI
Valley Grove Inpatient Services, PLLC
- Internal Medicine Physician
- Jackson, TN
National Provider Identifier
1558797993
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- VALLEY GROVE INPATIENT SERVICES, PLLC
- Practice address
- 367 Hospital Blvd
Jackson, TN 38305-2080 - Phone
- (731) 661-2000
- NPI assigned
- Sep 17, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kathy Kondas
- Title
- Officer
- Phone
- (973) 251-1132
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | Primary |
Addresses
Primary practice location
367 Hospital Blvd
Jackson, TN 38305-2080
Mailing address
815 S Palafox St
3Rd Floor
Pensacola, FL 32502-5960
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1379376000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1575504000000",
"number": "1558797993",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "815 S PALAFOX ST",
"address_2": "3RD FLOOR",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "325025960"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "367 HOSPITAL BLVD",
"city": "JACKSON",
"state": "TN",
"postal_code": "383052080",
"telephone_number": "731-661-2000"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "VALLEY GROVE INPATIENT SERVICES, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2013-09-17",
"last_updated": "2019-12-05",
"status": "A",
"authorized_official_last_name": "KONDAS",
"authorized_official_first_name": "KATHY",
"authorized_official_title_or_position": "OFFICER",
"authorized_official_telephone_number": "973-251-1132"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jackson, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.