NPIMap

Organization Active NPI

Omni Community Health

  • Mental Health Counselor
  • Lebanon, TN
National Provider Identifier
1730238155
Registry record updated Sep 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
L 214-017-3652 Issued in TN
Legal business name
OMNI COMMUNITY HEALTH
Practice address
1420 W. Baddour Parkway
Suite 240
Lebanon, TN 37087-1510
Phone
(615) 453-1606
Fax
(615) 453-1607
NPI assigned
Jan 9, 2007
Last updated
Sep 2, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2020

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

Authorized official

Name
Mark Just
Title
Chief Executive Officer
Phone
(615) 726-3603

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X L 214-017-3652 TN
Family Nurse Practitioner 363LF0000X L 214-017-3652 TN
Psychiatric/Mental Health Nurse Practitioner 363LP0808X L 214-017-3652 TN
Mental Health Counselor 101YM0800X L 214-017-3652 TN Primary
Social Worker 104100000X L 214-017-3652 TN
Marriage & Family Therapist 106H00000X L 214-017-3652 TN
Community Health Registered Nurse 163WC1500X L 214-017-3652 TN
Licensed Practical Nurse 164W00000X L 214-017-3652 TN
Psychiatry Physician 2084P0800X L 214-017-3652 TN

Addresses

Primary practice location

1420 W. Baddour Parkway
Suite 240
Lebanon, TN 37087-1510

Mailing address

301 S Perimeter Park Drive
Suite 210
Nashville, TN 37211-4128
Phone (615) 726-3603

Other identifiers 2

IdentifierTypeStateIssuer
Q019925MedicaidTN
3376955MedicaidTN

National Provider Directory

National Provider Directory
Tax ID family
Omni Community Health Inc11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Locations

417 Harding Dr
Ste B
Lebanon, TN 37087
Phone (615) 453-1606

446 Metroplex Dr
Ste A100
Nashville, TN 37211
Phone (615) 781-0013

Practitioners & affiliated clinicians

Practitioners 10

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": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599004800000",
    "number": "1730238155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 S PERIMETER PARK DRIVE",
            "address_2": "SUITE 210",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372114128",
            "telephone_number": "615-726-3603",
            "fax_number": "615-827-0421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 W. BADDOUR PARKWAY",
            "address_2": "SUITE 240",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370871510",
            "telephone_number": "615-453-1606",
            "fax_number": "615-453-1607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMNI COMMUNITY HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2020-09-02",
        "certification_date": "2020-09-02",
        "status": "A",
        "authorized_official_last_name": "JUST",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "615-726-3603"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "TN",
            "license": "L 214-017-3652",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "L 214-017-3652",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "L 214-017-3652",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TN",
            "license": "L 214-017-3652",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TN",
            "license": "L 214-017-3652",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TN",
            "license": "L 214-017-3652",
            "primary": false
        },
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "TN",
            "license": "L 214-017-3652",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "TN",
            "license": "L 214-017-3652",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TN",
            "license": "L 214-017-3652",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q019925",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3376955",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 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.