Organization Active NPI

Genetic Assays, Inc.

  • Clinical Medical Laboratory
  • Nashville, TN
National Provider Identifier
1568569796
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
0000003268 Issued in TN
Legal business name
GENETIC ASSAYS, INC.
Practice address
4711 Trousdale Dr
Suite 209
Nashville, TN 37220-1321
Phone
(615) 781-0709
Fax
(615) 781-0766
NPI assigned
Sep 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Authorized official

Name
Mr. Mike A Mammarelli
Title
President / Ceo
Phone
(615) 781-0709

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 0000003268 TN Primary

Addresses

Primary practice location

4711 Trousdale Dr
Suite 209
Nashville, TN 37220-1321

Mailing address

4711 Trousdale Dr
Suite 209
Nashville, TN 37220-1321
Phone (615) 781-0709

Other identifiers 4

IdentifierTypeStateIssuer
690000007MedicaidAL
0202182OtherTNBLUE CROSS BLUE SHIELD TN
1710195235OtherTNMEDICAL DIRECTOR
37000866MedicaidKY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100826000115 TN Part B Supplier - Independent Clinical Laboratory 9931223021 Practice locations: Nashville, TN

National Provider Directory

National Provider Directory

Locations

4711 Trousdale Dr
Ste 209
Nashville, TN 37220
Phone (615) 781-0709

Practitioners & affiliated clinicians

Practitioners 1

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": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731974400000",
    "number": "1568569796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4711 TROUSDALE DR",
            "address_2": "SUITE 209",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372201321",
            "telephone_number": "615-781-0709",
            "fax_number": "615-781-0766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4711 TROUSDALE DR",
            "address_2": "SUITE 209",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372201321",
            "telephone_number": "615-781-0709",
            "fax_number": "615-781-0766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENETIC ASSAYS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A",
        "authorized_official_last_name": "MAMMARELLI",
        "authorized_official_first_name": "MIKE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT / CEO",
        "authorized_official_telephone_number": "615-781-0709",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "TN",
            "license": "0000003268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "690000007",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD TN",
            "identifier": "0202182",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL DIRECTOR",
            "identifier": "1710195235",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "37000866",
            "state": "KY"
        }
    ],
    "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 Nov 19, 2024; 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.