Geremy D. Medlock, DMD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

12260 Issued in TN

Practice address

1801 Meharry Blvd.
Nashville, TN 37208-3501

Phone

(803) 212-8290

NPI assigned

Jul 30, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1659139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691712000000",
    "number": "1780310730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2856 HOLLY GLEN DR APT G",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278348840",
            "telephone_number": "803-212-8290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 MEHARRY BLVD.",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372083501",
            "telephone_number": "803-212-8290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDLOCK",
        "first_name": "GEREMY",
        "middle_name": "D.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-30",
        "last_updated": "2023-08-11",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TN",
            "license": "12260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meditech Solutions LLC
• Meditranz, LLC
• Meditrina Consulting LLC
• Mary Caitlin Medley
• Theresa Rochelle Medley
• Medlogic Billing LLC
• Medtrack, LLC
• Andrew James Medvecz, M.D., M.P.H.
• Gleb Medvedev, M.D.
• Lauren Medwed, D.M.D.

• Student in an Organized Health Care Education/Training Program in Nashville, TN
• Providers in Nashville, TN by specialty
• Student in an Organized Health Care Education/Training Program in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.