NPIMap

Organization Active NPI

Middle Tennessee Urgent Care & Occupational Medicine Clinic, LLC

  • Specialist
  • Mt. Juliet, TN
National Provider Identifier
1760425045
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
25086 Issued in TN
Legal business name
MIDDLE TENNESSEE URGENT CARE & OCCUPATIONAL MEDICINE CLINIC, LLC
Doing business as
Middle TN. Urgent Care & Occupational Medicine Clinic
Practice address
5002 Crossing Circle
Suite 100
Mt. Juliet, TN 37122-8471
Phone
(615) 515-9111
Fax
(615) 564-9111
NPI assigned
Jun 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Charles Robert Kaelin Jr., M.D.
Title
Owner
Phone
(615) 553-5500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 25086 TN Primary

Addresses

Primary practice location

5002 Crossing Circle
Suite 100
Mt. Juliet, TN 37122-8471

Mailing address

5002 Crossing Circle
Suite 100
Mt. Juliet, TN 37122-8471
Phone (615) 515-9111

Other identifiers 1

IdentifierTypeStateIssuer
25086OtherTNDR. KAELIN'S LICENSE

Other names 1

  • Middle TN. Urgent Care & Occupational Medicine Clinic Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1760425045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5002 CROSSING CIRCLE",
            "address_2": "SUITE 100",
            "city": "MT. JULIET",
            "state": "TN",
            "postal_code": "371228471",
            "telephone_number": "615-515-9111",
            "fax_number": "615-564-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5002 CROSSING CIRCLE",
            "address_2": "SUITE 100",
            "city": "MT. JULIET",
            "state": "TN",
            "postal_code": "371228471",
            "telephone_number": "615-515-9111",
            "fax_number": "615-564-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDDLE TENNESSEE URGENT CARE & OCCUPATIONAL MEDICINE CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KAELIN",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "615-553-5500",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "TN",
            "license": "25086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR. KAELIN'S LICENSE",
            "identifier": "25086",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Middle TN. Urgent Care & Occupational Medicine Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mt. Juliet, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.