NPIMap

Organization Active NPI

Tennessee Sports Medicine, PC

  • Orthopaedic Surgery Physician
  • Cookeville, TN
National Provider Identifier
1699281451
Registry record updated Dec 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
TENNESSEE SPORTS MEDICINE, PC
Practice address
799 S Willow Ave
Cookeville, TN 38501-5997
Phone
(615) 553-5000
NPI assigned
Dec 15, 2017
Last updated
Dec 15, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2017

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

Authorized official

Name
Charles Robert KaelinNPI 1861469017
Title
Owner
Phone
(615) 758-1010

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X NU Primary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X NU

Addresses

Primary practice location

799 S Willow Ave
Cookeville, TN 38501-5997

Mailing address

1286 Oak Grove Rd Ste 100
Birmingham, AL 35209-6955

National Provider Directory

National Provider Directory
Tax ID family
Tennessee Sports Medicine PC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Practitioners & affiliated clinicians

Practitioners 1

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": "1513296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513296000000",
    "number": "1699281451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1286 OAK GROVE RD STE 100",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352096955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "799 S WILLOW AVE",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385015997",
            "telephone_number": "615-553-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TENNESSEE SPORTS MEDICINE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-15",
        "last_updated": "2017-12-15",
        "status": "A",
        "authorized_official_last_name": "KAELIN",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "615-758-1010"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cookeville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2017; 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.