Organization Active NPI

M a M LLC

  • Internal Medicine Physician
  • Nashville, TN
National Provider Identifier
1730246455
Registry record updated Oct 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
M A M LLC
Practice address
397 Wallace Rd Ste C300
Nashville, TN 37211-8020
Phone
(615) 333-3033
Fax
(615) 333-9912
NPI assigned
Jan 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2013

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

Authorized official

Name
Ms. Elizabeth Hood
Title
Billing
Phone
(615) 333-0330

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

397 Wallace Rd Ste C300
Nashville, TN 37211-8020

Mailing address

397 Wallace Rd Ste C300
Nashville, TN 37211-8020
Phone (615) 333-3033

Other identifiers 1

IdentifierTypeStateIssuer
4080481OtherBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040901000968 TN Part B Supplier - Clinic/Group Practice 9638144611 Receives reassigned benefits from 2 practitioners
Practice locations: Nashville, TN

National Provider Directory

National Provider Directory

Locations

397 Wallace Rd
Ste 300
Nashville, TN 37211
Phone (615) 333-0330

Practitioners & affiliated clinicians

Practitioners 3

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": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382486400000",
    "number": "1730246455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "397 WALLACE RD STE C300",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372118020",
            "telephone_number": "615-333-3033",
            "fax_number": "615-333-9912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "397 WALLACE RD STE C300",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372118020",
            "telephone_number": "615-333-3033",
            "fax_number": "615-333-9912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M A M LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2013-10-23",
        "status": "A",
        "authorized_official_last_name": "HOOD",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "615-333-0330",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4080481",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.