NPIMap

Organization Active NPI

Primary Care at Puc

  • Primary Care Clinic/Center
  • Brentwood, TN
National Provider Identifier
1669164232
Registry record updated May 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
PRIMARY CARE AT PUC
Practice address
700 Old Hickory Blvd Ste 208
Brentwood, TN 37027-5462
Phone
(615) 457-3864
Fax
(615) 457-3876
NPI assigned
May 23, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2023

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

Authorized official

Name
Jason Rubino, MDNPI 1952456527
Title
Managing Partner
Phone
(615) 457-3864

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

700 Old Hickory Blvd Ste 208
Brentwood, TN 37027-5462

Mailing address

155 Covey Dr Ste 100
Franklin, TN 37067-6019
Phone (615) 472-1550

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240222003102 TN Part B Supplier - Clinic/Group Practice 8820432339 Receives reassigned benefits from 5 practitioners
Practice locations: Brentwood, TN; Franklin, TN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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": "1684800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684800000000",
    "number": "1669164232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 COVEY DR STE 100",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370676019",
            "telephone_number": "615-472-1550",
            "fax_number": "615-472-1659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 OLD HICKORY BLVD STE 208",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275462",
            "telephone_number": "615-457-3864",
            "fax_number": "615-457-3876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE AT PUC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-23",
        "last_updated": "2023-05-23",
        "certification_date": "2023-05-23",
        "status": "A",
        "authorized_official_last_name": "RUBINO",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "615-457-3864",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2023; 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.