NPIMap

Organization Active NPI

University Health System, Inc

Doing business as UT Family Physicians Clinton

  • Family Medicine Physician
  • Clinton, TN
National Provider Identifier
1578886610
Registry record updated Jun 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
UNIVERSITY HEALTH SYSTEM, INC
Doing business as
UT Family Physicians Clinton
Practice address
2681 Andersonville Hwy
Ste 102
Clinton, TN 37716-6706
Phone
(865) 494-5960
Fax
(865) 494-5964
NPI assigned
Mar 3, 2010
Last updated
Jun 5, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2020

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

Authorized official

Name
Beth A Maynard
Title
Vice President
Phone
(865) 305-6427

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

2681 Andersonville Hwy
Ste 102
Clinton, TN 37716-6706

Mailing address

PO Box 415000-Msc8162
Nashville, TN 37241-8162
Phone (865) 670-6199

Other identifiers 1

IdentifierTypeStateIssuer
1518343MedicaidTN

Other names 1

  • UT Family Physicians Clinton Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031111000809 TN Part B Supplier - Clinic/Group Practice 5294646378 Receives reassigned benefits from 881 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Locations

2681 Andersonville Hwy
Clinton, TN 37716
Phone (865) 457-2020

1926 Alcoa Hwy
Ste 410
Knoxville, TN 37920
Phone (865) 305-5622

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1267574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591315200000",
    "number": "1578886610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415000-MSC8162",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372418162",
            "telephone_number": "865-670-6199",
            "fax_number": "865-670-6198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2681 ANDERSONVILLE HWY",
            "address_2": "STE 102",
            "city": "CLINTON",
            "state": "TN",
            "postal_code": "377166706",
            "telephone_number": "865-494-5960",
            "fax_number": "865-494-5964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY HEALTH SYSTEM, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-03",
        "last_updated": "2020-06-05",
        "certification_date": "2020-06-05",
        "status": "A",
        "authorized_official_last_name": "MAYNARD",
        "authorized_official_first_name": "BETH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "865-305-6427"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1518343",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UT Family Physicians Clinton",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "UT Family Physicians Clinton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clinton, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2020; 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.