Active NPI
Mark Edwin Frisse
- Internal Medicine Physician
- Nashville, TN
National Provider Identifier
1780129858
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- R3A00
- Practice address
- 3707 Wimbledon Rd
Nashville, TN 37215-1819 - Phone
- (615) 720-7761
- Fax
- (615) 936-0102
- NPI assigned
- Dec 28, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | R3A00 | MO | Primary |
Addresses
Primary practice location
3707 Wimbledon Rd
Nashville, TN 37215-1819
Mailing address
3707 Wimbledon Rd
Nashville, TN 37215-1819
Phone (615) 720-7761
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| R3A00 | Other | MO | STATE LICENSURE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R3A00 | MO | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1482883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1482883200000",
"number": "1780129858",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3707 WIMBLEDON RD",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372151819",
"telephone_number": "615-720-7761",
"fax_number": "615-936-0102"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3707 WIMBLEDON RD",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372151819",
"telephone_number": "615-720-7761",
"fax_number": "615-936-0102"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRISSE",
"first_name": "MARK",
"middle_name": "EDWIN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-12-28",
"last_updated": "2016-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MO",
"license": "R3A00",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSURE",
"identifier": "R3A00",
"state": "MO"
}
],
"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 Dec 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.