Active NPI
Family Health Care of Hendersonville, PLLC
- Family Medicine Physician
- Hendersonville, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- FAMILY HEALTH CARE OF HENDERSONVILLE, PLLC
- Practice address
- 211 Indian Lake Blvd Ste a
Hendersonville, TN 37075-6442 - Phone
- (615) 826-3100
- Fax
- (615) 447-1060
- NPI assigned
- Jan 9, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Anthony V. Dallas Jr., MD
- Title
- Owner
- Phone
- (615) 826-3100
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
211 Indian Lake Blvd Ste a
Hendersonville, TN 37075-6442
Mailing address
211 Indian Lake Blvd Ste a
Hendersonville, TN 37075-6442
Phone (615) 826-3100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3374461 | Medicaid | TN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040116000305 | TN | Part B Supplier - Clinic/Group Practice | 1850292426 |
Receives reassigned benefits from 8 practitioners 1 other NPI on this enrollment Practice locations: Hendersonville, TN |
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Family Medicine Physician
- Hendersonville, TN
- NPI 1326073396
O20040116000305
National Provider Directory
National Provider DirectoryLocations
211 Indian Lake Blvd
Ste A
Hendersonvlle, TN 37075
Phone (615) 826-3100
353 New Shackle Island Rd
Ste 141C
Hendersonvlle, TN 37075
Phone (615) 826-3100
Practitioners & affiliated clinicians
Practitioners 8
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Hendersonville, TN
- NPI 1861437063
-
- Family Nurse Practitioner
- Portland, TN
- NPI 1578446753
-
- Family Nurse Practitioner
- Gallatin, TN
- NPI 1962668210
-
- Family Nurse Practitioner
- Nashville, TN
- NPI 1619609146
-
- Family Nurse Practitioner
- Hendersonville, TN
- NPI 1265235600
-
- Family Nurse Practitioner
- Hendersonville, TN
- NPI 1902686215
-
- Family Nurse Practitioner
- Gallatin, TN
- NPI 1043986045
-
- Family Nurse Practitioner
- Hendersonville, TN
- NPI 1003114737
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1357689600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1697760000000",
"number": "1699012716",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "211 INDIAN LAKE BLVD STE A",
"city": "HENDERSONVILLE",
"state": "TN",
"postal_code": "370756442",
"telephone_number": "615-826-3100",
"fax_number": "615-447-1060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "211 INDIAN LAKE BLVD STE A",
"city": "HENDERSONVILLE",
"state": "TN",
"postal_code": "370756442",
"telephone_number": "615-826-3100",
"fax_number": "615-447-1060"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FAMILY HEALTH CARE OF HENDERSONVILLE, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2013-01-09",
"last_updated": "2023-10-20",
"certification_date": "2023-10-20",
"status": "A",
"authorized_official_last_name": "DALLAS",
"authorized_official_first_name": "ANTHONY",
"authorized_official_middle_name": "V.",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "615-826-3100",
"authorized_official_name_prefix": "Dr.",
"authorized_official_name_suffix": "Jr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3374461",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Hendersonville, TN
- F William Taylor DDS Ms PC
- Sarah Fairchild
- Patricia Mae Fajardo, FNP-C
- Family Health Care of Hendersonville II LLC
- Family Health Care of Hendersonville, PLLC
- Family Time Medical Clinic
- Family Urgent Care, LLC
- Family Wellness Connection, PLLC
- Family Wellness Group of Middle Tennessee LLC
- Fast Pace Medical Clinic PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 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.