NPIMap

Organization Active NPI

Trousdale Medical Clinic

  • Family Medicine Physician
  • Hartsville, TN
National Provider Identifier
1669765442
Registry record updated May 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
16864 Issued in TN
Legal business name
TROUSDALE MEDICAL CLINIC
Practice address
205 Broadway
Hartsville, TN 37074-1303
Phone
(615) 374-0703
Fax
(615) 374-0019
NPI assigned
May 26, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2011

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

Authorized official

Name
William D Lyles Jr., MDNPI 1801001912
Title
Chief Executive Officer
Phone
(615) 374-0703

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 16864 TN Primary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X 16864 TN

Addresses

Primary practice location

205 Broadway
Hartsville, TN 37074-1303

Mailing address

205 Broadway
P.O. Box 483
Hartsville, TN 37074-1303
Phone (615) 374-0703

National Provider Directory

National Provider Directory

Locations

205 Broadway
Hartsville, TN 37074
Phone (615) 374-0317

205A Broadway
Hartsville, TN 37074
Phone (615) 374-0703

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": "1306368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306368000000",
    "number": "1669765442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 BROADWAY",
            "address_2": "P.O. BOX 483",
            "city": "HARTSVILLE",
            "state": "TN",
            "postal_code": "370741303",
            "telephone_number": "615-374-0703",
            "fax_number": "615-374-0019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 BROADWAY",
            "city": "HARTSVILLE",
            "state": "TN",
            "postal_code": "370741303",
            "telephone_number": "615-374-0703",
            "fax_number": "615-374-0019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TROUSDALE MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-26",
        "last_updated": "2011-05-26",
        "status": "A",
        "authorized_official_last_name": "LYLES",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "615-374-0703",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "16864",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "TN",
            "license": "16864",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartsville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2011; 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.