Jack Michael Friday, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

MD25800 Issued in TN

Practice address

3024 Business Park Cir
Goodlettsville, TN 37072-3132

Phone

(615) 851-6033

Fax

(615) 851-2018

NPI assigned

Jun 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 10

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Columbia St. Mary'S Hospital Milwaukee, Inc

  • Multi-Specialty Clinic/Center
  • Milwaukee, WI
  • NPI 1023064482
  Medicare reassignment NPD
• Middle Tennessee Imaging LLC

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Nashville, TN
  • NPI 1750889242
  NPD
• Middle Tennessee Imaging, LLC

  • Mobile Radiology Clinic/Center
  • Nashville, TN
  • NPI 1629434394
  NPD
• Middle Tennessee Imaging, LLC

  • Radiology Clinic/Center
  • Nashville, TN
  • NPI 1932686318
  NPD
• Columbia St. Mary'S Hospital Milwaukee Inc

  • Multi-Specialty Clinic/Center
  • Milwaukee, WI
  • NPI 1225071491
  NPD
• Columbia St. Mary'S Hospital Milwaukee Inc

  • Psychiatric Hospital Unit
  • Mequon, WI
  • NPI 1417600909
  NPD
• K. Brian Walton, MD, PLC

  • Surgery Physician
  • Goodlettsville, TN
  • NPI 1528104908
  NPD (past)
• National Imaging Specialists PLLC

  • Diagnostic Radiology Physician
  • Goodlettsville, TN
  • NPI 1679746457
  NPD (past)
• Sacred Heart Rehabilitation Institute, Inc.

  • Rehabilitation Hospital
  • Mequon, WI
  • NPI 1508920356
  NPD (past)

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322611200000",
    "number": "1700825940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3024 BUSINESS PARK CIR",
            "city": "GOODLETTSVILLE",
            "state": "TN",
            "postal_code": "370723132",
            "telephone_number": "615-851-6033",
            "fax_number": "615-851-2018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3024 BUSINESS PARK CIR",
            "city": "GOODLETTSVILLE",
            "state": "TN",
            "postal_code": "370723132",
            "telephone_number": "615-851-6033",
            "fax_number": "615-851-2018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIDAY",
        "first_name": "JACK",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2011-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TN",
            "license": "MD25800",
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "TN",
            "license": "25800",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "3031174",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS - MTI",
            "identifier": "4291356",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID - MTI",
            "identifier": "1509266",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "300108653",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3083732",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "3136571",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TN",
            "identifier": "4200799",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KY MEDICAID",
            "identifier": "64924590",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6492459000",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1509266",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephen Michael Fisher, MD
• Fluency ABA, LLC
• Joseph Albert Fox, D.D.S.
• Roderick Vincent Frazier, DDS
• Fresenius Medical Care Goodlettsville, LLC
• FTP Non Profit
• Gabriel, LLC
• Charles Zachary Gammill, DC
• Daniel Geare, DMD
• Meredith Jeanne Gibbs

• Diagnostic Radiology Physician in Goodlettsville, TN
• Providers in Goodlettsville, TN by specialty
• Diagnostic Radiology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.