Active NPI
Stonecrest Medical Group - Family Practice of Murfreesboro LLC
- Family Medicine Physician
- Murfreesboro, TN
National Provider Identifier
1639376353
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- STONECREST MEDICAL GROUP - FAMILY PRACTICE OF MURFREESBORO LLC
- Practice address
- 2706 Old Fort Parkway
Suite E
Murfreesboro, TN 37128 - Phone
- (615) 893-1230
- Fax
- (615) 893-1232
- NPI assigned
- Jun 27, 2007
- Organization subpart
- Yes
- Parent organization
- HEALTHSERV ACQUISITION LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Chuck Locke
- Title
- Vice President
- Phone
- (615) 373-7604
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
2706 Old Fort Parkway
Suite E
Murfreesboro, TN 37128
Mailing address
2706 Old Fort Parkway
Suite E
Murfreesboro, TN 37128
Phone (615) 893-1230
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3370137 | Medicaid | TN |
Other names 1
- MidState Family Medicine and Urgent Care
National Provider Directory
National Provider DirectoryLocations
2706 Old Fort Pkwy
Ste E
Murfreesboro, TN 37128
Phone (615) 624-6299
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": "1182902400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1195257600000",
"number": "1639376353",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2706 OLD FORT PARKWAY",
"address_2": "SUITE E",
"city": "MURFREESBORO",
"state": "TN",
"postal_code": "37128",
"telephone_number": "615-893-1230",
"fax_number": "615-893-1232"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2706 OLD FORT PARKWAY",
"address_2": "SUITE E",
"city": "MURFREESBORO",
"state": "TN",
"postal_code": "37128",
"telephone_number": "615-893-1230",
"fax_number": "615-893-1232"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "STONECREST MEDICAL GROUP - FAMILY PRACTICE OF MURFREESBORO LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "HEALTHSERV ACQUISITION LLC",
"enumeration_date": "2007-06-27",
"last_updated": "2007-11-17",
"status": "A",
"authorized_official_last_name": "LOCKE",
"authorized_official_first_name": "CHUCK",
"authorized_official_title_or_position": "VICE PRESIDENT",
"authorized_official_telephone_number": "615-373-7604"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3370137",
"state": "TN"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "MidState Family Medicine and Urgent Care",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Murfreesboro, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.