Cedar Recovery Center of Middle Tennessee, LLC
Organization Active NPI Addiction Medicine (Preventive Medicine) Physician · Columbia, TN
NPI 1801345285 · NPPES record last updated Oct 24, 2023
Key facts
- NPI
- 1801345285
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Addiction Medicine (Preventive Medicine) Physician 2083A0300X
- Legal business name
- CEDAR RECOVERY CENTER OF MIDDLE TENNESSEE, LLC
- Practice address
- 1512 Hatcher LN
Columbia, TN 38401-4825 - Phone
- (931) 948-8882
- Fax
- (931) 223-8717
- NPI assigned
- Sep 27, 2016
- Organization subpart
- No
Authorized official
- Name
- Joseph Bond
- Title
- Owner
- Phone
- (615) 680-0110
Other NPIs with the same Medicare PAC ID 1
Member organizations 1
Practitioners 78
-
Janice Alder, LPC-MHSP, NCC
-
Stephanie Anderson, LPC-MHSP
-
Robin Jean Barnett, LPC-MHSP
-
Mary Beth Bever, FNP
-
Mary Jane Brown, M.D.
-
Sonya Lavet Butler, PMHNP-BC
-
Justin Davis, PMHNP
-
Kimberly Dobbyn, APN
-
Alicia Ellis, NP
-
Keira Fierst, LPC-MHSP
-
Karen Louise Golden, FNP
-
Harrison M Gray, M.D.
-
James T Harrison, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TN, VA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200529001321 | TN | Part B Supplier - Clinic/Group Practice | 0446671440 |
Receives reassigned benefits from 73 practitioners Practice locations: Shelbyville, TN; Clarksville, TN; Nashville, TN; Mt Juliet, TN; Lebanon, TN; Knoxville, TN; Cookeville, TN; Columbia, TN… |
| O20240216001416 | VA | Part B Supplier - Clinic/Group Practice | 0446671440 |
Receives reassigned benefits from 6 practitioners Practice locations: Bristol, VA |
National Provider Directory
Locations
17 W Madison Ave
Athens, TN 37303
Phone (423) 717-2240
506 N High St
Columbia, TN 38401
Phone (931) 223-5455
1512 Hatcher Ln
Columbia, TN 38401
Phone (615) 257-6844
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction Medicine (Preventive Medicine) Physician |
2083A0300X | Yes | ||
| Adult Mental Health Clinic/Center | 261QM0850X | |||
| Psychiatric Hospital | 283Q00000X |
Addresses
Primary practice location
1512 Hatcher LN
Columbia, TN 38401-4825
Mailing address
5000 Crossings Cir Ste 103
Mount Juliet, TN 37122-8591
Phone (615) 288-1103
Other practice location 1
2839 Highway 231 N Ste 101
Shelbyville, TN 37160-7448
Phone (931) 488-4814
Other practice location 2
2636 N Mount Juliet Rd
Mount Juliet, TN 37122-8015
Phone (615) 680-0110
Other practice location 3
1405 W Baddour Pkwy Ste 101
Lebanon, TN 37087-2595
Phone (615) 994-1288
Other practice location 4
8712 Asheville Hwy
Knoxville, TN 37924-4501
Phone (865) 932-3633
Other practice location 5
2805 W Governor John Sevier Hwy
Knoxville, TN 37920-5552
Phone (865) 298-3558
Other practice location 6
17 W Madison Ave
Athens, TN 37303-4251
Phone (423) 717-2240
Other practice location 7
291 Clear Sky Ct Ste F
Clarksville, TN 37043-5951
Phone (931) 444-7020
Other practice location 8
170 Blevins Blvd
Bristol, VA 24202-6021
Phone (276) 285-3911
Other practice location 9
2525 Perimeter Place Dr Ste 105
Nashville, TN 37214-3674
Phone (615) 680-0110
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Q024355 | Medicaid | TN |
Other providers in Columbia, TN
- Josiedith Castaneda
- Karol Ann Cathey
- Vincent Salvatore Cavaliere
- Elizabeth Frances Cazan
- CCS Care Clinic LLC
- Cedar Recovery of Middle Tennessee, LLC
- Kevin J Cefali
- Center for Dental Health
- Center for Sleep and Snoring, LLC
- Centerstone
All providers in Columbia, TN · Addiction Medicine (Preventive Medicine) Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 24, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.