NPIMap

Organization Active NPI

Novus Behavioral Health

  • Physician Assistant
  • Clarksville, TN
National Provider Identifier
1770078040
Registry record updated Jun 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA1475 Issued in TN
Legal business name
NOVUS BEHAVIORAL HEALTH
Practice address
130 Hillcrest Dr Ste 213
Clarksville, TN 37043-5083
Phone
(931) 820-0242
NPI assigned
Jun 28, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2018

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

Authorized official

Name
Scarlett Cae Mulligan, PANPI 1679628713
Title
Owner/Provider
Phone
(931) 820-0242

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X PA1475 TN Primary

Addresses

Primary practice location

130 Hillcrest Dr Ste 213
Clarksville, TN 37043-5083

Mailing address

130 Hillcrest Dr Ste 213
Clarksville, TN 37043-5083
Phone (931) 820-0242

Other names 1

  • NOVUS BEHAVIORAL HEALTH Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191011002464 TN Part B Supplier - Clinic/Group Practice 3173854759 Receives reassigned benefits from 12 practitioners
Practice locations: Clarksville, TN

National Provider Directory

National Provider Directory

Locations

130 Hillcrest Dr
Ste 213
Clarksville, TN 37043
Phone (931) 820-0242

556 Fire Station Rd
Ste A
Clarksville, TN 37043
Phone (931) 820-0242

1840 Memorial Dr
Clarksville, TN 37043
Phone (931) 249-1081

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1530144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530144000000",
    "number": "1770078040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 HILLCREST DR STE 213",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370435083",
            "telephone_number": "931-820-0242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 HILLCREST DR STE 213",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370435083",
            "telephone_number": "931-820-0242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVUS BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-28",
        "last_updated": "2018-06-28",
        "status": "A",
        "authorized_official_last_name": "MULLIGAN",
        "authorized_official_first_name": "SCARLETT",
        "authorized_official_middle_name": "CAE",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "931-820-0242",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "PA1475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NOVUS BEHAVIORAL HEALTH",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NOVUS BEHAVIORAL HEALTH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clarksville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2018; 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.