Bluebird Recovery LLC

Primary specialty

Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X

Legal business name

BLUEBIRD RECOVERY LLC

Practice address

127 Ledford Mill Rd Ste B
Tullahoma, TN 37388-2278

Phone

(931) 841-3311

Fax

(931) 841-3314

NPI assigned

Jan 4, 2023

Last updated

Sep 28, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Chasity J Tankersley

Title

Office Manager

Phone

(931) 841-3311

Specialties & licenses 2

Addresses

Locations

Practitioners 2

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.

• Paul M Haidak, MD

  • General Practice Physician
  • Tullahoma, TN
  • NPI 1871612515
  NPD
• Robert F Kasa, MD

  • General Practice Physician
  • Tullahoma, TN
  • NPI 1891793956
  NPD

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

{
    "created_epoch": "1672790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695859200000",
    "number": "1730892837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 LEDFORD MILL RD STE B",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373882278",
            "telephone_number": "931-841-3311",
            "fax_number": "931-841-3314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 LEDFORD MILL RD STE B",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373882278",
            "telephone_number": "931-841-3311",
            "fax_number": "931-841-3314"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "161 Mose Dr",
            "address_purpose": "LOCATION",
            "city": "Sparta",
            "state": "TN",
            "postal_code": "385831502",
            "country_code": "US",
            "telephone_number": "931-222-0139",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4140 Thornton Taylor Pkwy Ste D",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "TN",
            "postal_code": "373342290",
            "country_code": "US",
            "telephone_number": "931-434-8109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BLUEBIRD RECOVERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-04",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A",
        "authorized_official_last_name": "TANKERSLEY",
        "authorized_official_first_name": "CHASITY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "931-841-3311"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• BKD Tullahoma, LLC (Brookdale Tullahoma)
• Mark Blair, M.D.
• James Harrell Blanks, OD
• Jacqueline D. Blanton, ACNP
• Taylor Lanaux Blow, PAC
• Laurie Lynn Boland, M.A. CCC-SLP
• Jessica Nicole Bonar, MSN, APRN, AGACNP-BC
• Leanna Mashae Bonner
• Jennifer O'Neal Bowles
• Magen Michelle Boyd

• Addiction Medicine (Family Medicine) Physician in Tullahoma, TN
• Providers in Tullahoma, TN by specialty
• Addiction Medicine (Family Medicine) Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.