Stones River Regional Independent Practice Association

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

Legal business name

STONES RIVER REGIONAL INDEPENDENT PRACTICE ASSOCIATION

Practice address

1620 Gateway Blvd Ste 102
Murfreesboro, TN 37129

Phone

(615) 869-0030

Fax

(615) 869-0040

NPI assigned

Jan 28, 2011

Organization subpart

No

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

Authorized official

Name

Susan Vandagriff

Title

Credentialing Manager

Phone

(615) 869-0031

Specialties & licenses 1

Addresses

Other names 1

• Stones River Regional IPA Doing business as

Tax ID family

Lebanon Eye Assocstones River2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Lebanon Eye Assocstones River

  • Ophthalmology Physician
  • Murfreesboro, TN
  • NPI 1053533315
  NPD tax ID

Locations

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

{
    "created_epoch": "1296172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734652800000",
    "number": "1669778338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 GATEWAY BLVD STE 102",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "37129",
            "telephone_number": "615-869-0030",
            "fax_number": "615-869-0040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 GATEWAY BLVD STE 102",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "37129",
            "telephone_number": "615-869-0030",
            "fax_number": "615-869-0040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONES RIVER REGIONAL INDEPENDENT PRACTICE ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-28",
        "last_updated": "2024-12-20",
        "status": "A",
        "authorized_official_last_name": "VANDAGRIFF",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "615-869-0031"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stones River Regional IPA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stones River Manor, Inc.
• Stones River Medical Group PC
• Stones River Medical Management, P.C.
• Stones River Pain & Joint
• Stones River Psychiatric Group PC
• Stones River Rheumatology PLLC
• Stones River Surgical Group PLLC
• Maddison Brooke Storey
• Richard Malcolm Storie II, EDD, ACSM-EP
• Buffy Storm, D.D.S.

• Exclusive Provider Organization in Murfreesboro, TN
• Providers in Murfreesboro, TN by specialty
• Exclusive Provider Organization in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2024; 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.