Organization Active NPI

Stonecrest Medical Group - Family Practice of Murfreesboro LLC

  • Family Medicine Physician
  • Murfreesboro, TN
National Provider Identifier
1639376353
Registry record updated Nov 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
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 LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 17, 2007

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)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 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

IdentifierTypeStateIssuer
3370137MedicaidTN

Other names 1

  • MidState Family Medicine and Urgent Care Doing business as

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.