NPIMap

Organization Active NPI

Healthstar Medical Group PLLC

  • Urgent Care Clinic/Center
  • Clarksville, TN
National Provider Identifier
1801675426
Registry record updated Aug 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
HEALTHSTAR MEDICAL GROUP PLLC
Practice address
560 Fire Station Road
Clarksville, TN 37043-4016
Phone
(931) 368-9736
Fax
(931) 346-0097
NPI assigned
Sep 22, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2024

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

Authorized official

Name
Jigar Kanubhai ShahNPI 1013936079
Title
Physician
Phone
(931) 802-8056

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Urgent Care Clinic/Center 261QU0200X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

560 Fire Station Road
Clarksville, TN 37043-4016

Mailing address

1960 Madison St
Clarksville, TN 37043-8063
Phone (931) 368-9736

Other names 1

  • HealthStar Medical Group Clarksville Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240103000065 TN Part B Supplier - Clinic/Group Practice 6800246810 Receives reassigned benefits from 12 practitioners
Practice locations: Clarksville, TN

National Provider Directory

National Provider Directory

Locations

1110 Ted a Crozier SR Blvd
Clarksville, TN 37043
Phone (931) 320-9467

1960 Madison St
#326
Clarksville, TN 37043

1960 Madison St
Clarksville, TN 37043

Practitioners & affiliated clinicians

Practitioners 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1695340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724630400000",
    "number": "1801675426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1960 MADISON ST",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370438063",
            "telephone_number": "931-368-9736",
            "fax_number": "931-346-0097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 FIRE STATION ROAD",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370434016",
            "telephone_number": "931-368-9736",
            "fax_number": "931-346-0097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHSTAR MEDICAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-22",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "JIGAR",
        "authorized_official_middle_name": "KANUBHAI",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "931-802-8056"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HealthStar Medical Group Clarksville",
            "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 Aug 26, 2024; 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.