NPIMap

Organization Active NPI

Omni Community Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Murfreesboro, TN
National Provider Identifier
1770924284
Registry record updated Sep 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
OMNI COMMUNITY HEALTH
Practice address
545 Brandies Circle
Murfreesboro, TN 37128
Phone
(615) 295-2176
Fax
(615) 295-2645
NPI assigned
Jul 12, 2013
Last updated
Sep 14, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X TN Primary

Addresses

Primary practice location

545 Brandies Circle
Murfreesboro, TN 37128

Mailing address

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

Other practice location 1

1630 South Church Street
Suite 104
Murfreesboro, TN 37130
Phone (615) 781-0013

Other practice location 2

1630 South Church Street
Suite 104
Murfreesboro, TN 37130
Phone (615) 781-0013

Other identifiers 2

IdentifierTypeStateIssuer
Q019919MedicaidTN
3376955MedicaidTN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D2217755Omni Community Health - Murfreesboro545 Brandies Circle, Murfreesboro, TN 37128Certificate of waiverMar 22, 2027

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

1630 S Church St
Ste 104
Murfreesboro, TN 37130
Phone (615) 295-2176

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1373587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600041600000",
    "number": "1770924284",
    "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": "545 BRANDIES CIRCLE",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "37128",
            "telephone_number": "615-295-2176",
            "fax_number": "615-295-2645"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1630 South Church Street",
            "address_2": "Suite 104",
            "address_purpose": "LOCATION",
            "city": "Murfreesboro",
            "state": "TN",
            "postal_code": "37130",
            "country_code": "US",
            "telephone_number": "615-781-0013",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1630 South Church Street",
            "address_2": "Suite 104",
            "address_purpose": "LOCATION",
            "city": "Murfreesboro",
            "state": "TN",
            "postal_code": "37130",
            "country_code": "US",
            "telephone_number": "615-781-0013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "OMNI COMMUNITY HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-12",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "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": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "TN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q019919",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3376955",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Murfreesboro, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.