NPIMap

Organization Active NPI

Upper Cumberland Anesthesia Associates, PC

  • Pain Medicine (Anesthesiology) Physician
  • Cookeville, TN
National Provider Identifier
1710919980
Registry record updated Apr 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
UPPER CUMBERLAND ANESTHESIA ASSOCIATES, PC
Practice address
1 Medical Center Blvd
Cookeville, TN 38501-4294
Phone
(931) 528-5587
NPI assigned
Jul 7, 2006
Last updated
Apr 14, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2020

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

Authorized official

Name
Dr. Robert Harrison Landry, MDNPI 1003806837
Title
President
Phone
(931) 528-7877

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
Pain Medicine (Anesthesiology) Physician 207LP2900X NU Primary
Certified Registered Nurse Anesthetist 367500000X NU

Addresses

Primary practice location

1 Medical Center Blvd
Cookeville, TN 38501-4294

Mailing address

PO Box 280
Cookeville, TN 38503-0280
Phone (931) 528-7877

Other practice location 1

100 W 4th St
Suite 310
Cookeville, TN 38501-2448
Phone (931) 528-7877

Other identifiers 3

IdentifierTypeStateIssuer
65945206MedicaidKY
CD2499OtherMEDICARE RAILROAD
74904152MedicaidKY

National Provider Directory

National Provider Directory

Locations

100 W 4th St
Ste 310
Cookeville, TN 38501
Phone (931) 528-7877

Practitioners & affiliated clinicians

Practitioners 42

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.

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586822400000",
    "number": "1710919980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 280",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385030280",
            "telephone_number": "931-528-7877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER BLVD",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385014294",
            "telephone_number": "931-528-5587"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 W 4th St",
            "address_2": "Suite 310",
            "address_purpose": "LOCATION",
            "city": "Cookeville",
            "state": "TN",
            "postal_code": "385012448",
            "country_code": "US",
            "telephone_number": "931-528-7877",
            "fax_number": "931-526-3261",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "UPPER CUMBERLAND ANESTHESIA ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2020-04-14",
        "certification_date": "2020-04-14",
        "status": "A",
        "authorized_official_last_name": "LANDRY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "HARRISON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "931-528-7877",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65945206",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CD2499",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "74904152",
            "state": "KY"
        }
    ],
    "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 Apr 14, 2020; 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.