Medical Group Stonecrest Pulmonology LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MEDICAL GROUP STONECREST PULMONOLOGY LLC

Doing business as

Stonecrest Gateway Primary Care

Practice address

1725 Medical Center Pkwy
Suite 130
Murfreesboro, TN 37129-2246

Phone

(615) 494-3939

Fax

(615) 494-3941

NPI assigned

Dec 5, 2006

Last updated

Dec 11, 2007By 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

Jeff Rydburg

Title

VP

Phone

(615) 373-7415

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Stonecrest Gateway Primary Care Doing business as

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.

• Omar Louis Hamada, MD

  • Emergency Medicine Physician
  • Franklin, TN
  • NPI 1750358131

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197331200000",
    "number": "1659439396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 MEDICAL CENTER PKWY",
            "address_2": "SUITE 130",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371292246",
            "telephone_number": "615-494-3939",
            "fax_number": "615-494-3941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 MEDICAL CENTER PKWY",
            "address_2": "SUITE 130",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371292246",
            "telephone_number": "615-494-3939",
            "fax_number": "615-494-3941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL GROUP STONECREST PULMONOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2007-12-11",
        "status": "A",
        "authorized_official_last_name": "RYDBURG",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "615-373-7415"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3735729",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stonecrest Gateway Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kristie Mechoso, LPC-MHSP, LADAC II
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• Medical Personnel Services LLC
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• Family Medicine Physician in Murfreesboro, TN
• Providers in Murfreesboro, 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 Dec 11, 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.