Active NPI
Genetic Assays, Inc.
- Clinical Medical Laboratory
- Nashville, TN
National Provider Identifier
1568569796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- License
- 0000003268
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 690000007 | Medicaid | AL | |
| 0202182 | Other | TN | BLUE CROSS BLUE SHIELD TN |
| 1710195235 | Other | TN | MEDICAL DIRECTOR |
| 37000866 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100826000115 | TN | Part B Supplier - Independent Clinical Laboratory | 9931223021 | Practice locations: Nashville, TN |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Genetic Counselor (M.S.)
- Nashville, TN
- NPI 1760207922
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.