Hyde Park Medical Group, PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

HYDE PARK MEDICAL GROUP, PLLC

Practice address

49 Music SQ W
Nashville, TN 37203-3213

Phone

(773) 802-2723

NPI assigned

May 8, 2023

Last updated

May 29, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Khaisha Gist, MDNPI 1184011835

Title

Medical Director

Phone

(773) 802-2723

Specialties & licenses 1

Addresses

Tax ID family

Hyde Park Medical2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Hyde Park Medical Group, PLLC

  dba Hyde Park Medical

  • Family Medicine Physician
  • Smyrna, TN
  • NPI 1043903990
  NPD tax ID

Practitioners 1

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.

• Khaisha Verdelle Gist, M.D.

  • Family Medicine Physician
  • Smyrna, TN
  • NPI 1184011835

  Single Specialty

  NPD Authorized official

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

{
    "created_epoch": "1683504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685318400000",
    "number": "1598455123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23",
            "city": "GLADEVILLE",
            "state": "TN",
            "postal_code": "370710023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 MUSIC SQ W",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372033213",
            "telephone_number": "773-802-2723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HYDE PARK MEDICAL GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-08",
        "last_updated": "2023-05-29",
        "certification_date": "2023-05-29",
        "status": "A",
        "authorized_official_last_name": "GIST",
        "authorized_official_first_name": "KHAISHA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "773-802-2723",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barrington James Hwang, MD
• Carey Hwang, MD
• Samuel Hwang
• HWV Primary Care Clinic, PLLC (HWV Family Practice , PLLC)
• C Wade Hyatt III
• Anna Bliss Hyde
• Tristaca Hyde, SLP
• Taylor Hye, SLP
• Aranya Hyers, RN
• Adrian Hygge, FNP-C

• Family Medicine Physician in Nashville, TN
• Providers in Nashville, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.