Tristar Medical Group - Centennial Primary Care, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

TRISTAR MEDICAL GROUP - CENTENNIAL PRIMARY CARE, LLC

Practice address

330 23Rd Ave N
Suite 300
Nashville, TN 37203-1522

Phone

(615) 342-6800

Fax

(615) 342-6810

NPI assigned

Jun 14, 2012

Last updated

Oct 17, 2012By 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

Gary Duncan

Title

Vice President

Phone

(615) 886-4969

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1339632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350432000000",
    "number": "1679835623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 23RD AVE N",
            "address_2": "SUITE 150",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031522",
            "telephone_number": "615-342-6800",
            "fax_number": "615-342-6810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 23RD AVE N",
            "address_2": "SUITE 300",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031522",
            "telephone_number": "615-342-6800",
            "fax_number": "615-342-6810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRISTAR MEDICAL GROUP - CENTENNIAL PRIMARY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-14",
        "last_updated": "2012-10-17",
        "status": "A",
        "authorized_official_last_name": "DUNCAN",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "615-886-4969"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Nashville, TN
• Providers in Nashville, TN by specialty
• Internal Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2012; 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.