NPIMap

Organization Active NPI

Amg Hillside LLC

Doing business as Women's Complete Care

  • Obstetrics & Gynecology Physician
  • Pulaski, TN
National Provider Identifier
1629414719
Registry record updated May 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
AMG HILLSIDE LLC
Doing business as
Women's Complete Care
Practice address
1255 E College St
Suite 100
Pulaski, TN 38478-4515
Phone
(931) 424-6678
Fax
(931) 424-7113
NPI assigned
May 15, 2013
Last updated
May 15, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2013

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

Authorized official

Name
Jess N Judy
Title
President
Phone
(615) 565-1508

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

1255 E College St
Suite 100
Pulaski, TN 38478-4515

Mailing address

PO Box 632
Pulaski, TN 38478-0632
Phone (931) 424-6678

Other names 1

  • Women's Complete Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070810000665 TN Part B Supplier - Clinic/Group Practice 9436240017 Receives reassigned benefits from 55 practitioners
20 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Pulaski, TN; Lynnville, TN; Lewisburg, TN; Lawrenceburg, TN; Ardmore, TN

Other NPIs on the same Medicare enrollment 20

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 20

National Provider Directory

National Provider Directory
Tax ID family
Amg-Hillside LLC23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

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

View all 22

Practitioners & affiliated clinicians

Practitioners 2

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": "1368576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368576000000",
    "number": "1629414719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 632",
            "city": "PULASKI",
            "state": "TN",
            "postal_code": "384780632",
            "telephone_number": "931-424-6678",
            "fax_number": "931-424-7113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 E COLLEGE ST",
            "address_2": "SUITE 100",
            "city": "PULASKI",
            "state": "TN",
            "postal_code": "384784515",
            "telephone_number": "931-424-6678",
            "fax_number": "931-424-7113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMG HILLSIDE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-15",
        "last_updated": "2013-05-15",
        "status": "A",
        "authorized_official_last_name": "JUDY",
        "authorized_official_first_name": "JESS",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-565-1508"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Women's Complete Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pulaski, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2013; 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.