Organization Active NPI

SDM Tennessee PC

  • Procedural Dermatology Physician
  • Brentwood, TN
National Provider Identifier
1720591084
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Procedural Dermatology PhysicianTaxonomy code 207NS0135X
Legal business name
SDM TENNESSEE PC
Practice address
7100 Commerce Way Ste 160
Brentwood, TN 37027-2875
Phone
(615) 661-8818
NPI assigned
Nov 9, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2023

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

Authorized official

Name
David L Bryant
Title
Ceo
Phone
(980) 233-3200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Procedural Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207NS0135X Primary

Addresses

Primary practice location

7100 Commerce Way Ste 160
Brentwood, TN 37027-2875

Mailing address

3340 Robinwood Rd
Gastonia, NC 28054-6689
Phone (980) 233-3234

National Provider Directory

National Provider Directory

Locations

5955 Carnegie Blvd
Ste 300
Charlotte, NC 28209
Phone (980) 233-3200

7100 Commerce Way
Ste 160
Brentwood, TN 37027
Phone (615) 661-8818

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1510185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696377600000",
    "number": "1720591084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 ROBINWOOD RD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280546689",
            "telephone_number": "980-233-3234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7100 COMMERCE WAY STE 160",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370272875",
            "telephone_number": "615-661-8818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SDM TENNESSEE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-09",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A",
        "authorized_official_last_name": "BRYANT",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "980-233-3200"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; 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.