NPIMap

Organization Active NPI

Cumberland Occupational and Urgent Care Center LLC

  • Clinic/Center
  • Crossville, TN
National Provider Identifier
1689858664
Registry record updated Oct 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
CUMBERLAND OCCUPATIONAL AND URGENT CARE CENTER LLC
Practice address
118 Brown Ave
Suite 102
Crossville, TN 38555-7739
Phone
(931) 787-1990
Fax
(931) 787-1988
NPI assigned
Dec 26, 2007
Last updated
Oct 13, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2008

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

Authorized official

Name
Jon A Simpson, M.D.NPI 1295815850
Title
Owner
Phone
(931) 787-1990

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

118 Brown Ave
Suite 102
Crossville, TN 38555-7739

Mailing address

118 Brown Avenue
Suite 102
Crossville, TN 38555
Phone (931) 787-1990

Other identifiers 3

IdentifierTypeStateIssuer
1506712MedicaidTN
4173499OtherTNBCBS
P00619459OtherTNRAILROAD MEDICARE

National Provider Directory

National Provider Directory

Locations

118 Brown Ave
Ste 102
Crossville, TN 38555
Phone (931) 484-8861

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1198627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223856000000",
    "number": "1689858664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 BROWN AVENUE",
            "address_2": "SUITE 102",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "38555",
            "telephone_number": "931-787-1990",
            "fax_number": "931-787-1988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 BROWN AVE",
            "address_2": "SUITE 102",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385557739",
            "telephone_number": "931-787-1990",
            "fax_number": "931-787-1988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUMBERLAND OCCUPATIONAL AND URGENT CARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-26",
        "last_updated": "2008-10-13",
        "status": "A",
        "authorized_official_last_name": "SIMPSON",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "931-787-1990",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1506712",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4173499",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00619459",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crossville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2008; 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.