NPIMap

Organization Active NPI

Internal Medicine Associates of Tullahoma PC

Doing business as Internal Medicine Associates

  • Internal Medicine Physician
  • Tullahoma, TN
National Provider Identifier
1811094022
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4400309810 Issued in TN
Legal business name
INTERNAL MEDICINE ASSOCIATES OF TULLAHOMA PC
Doing business as
Internal Medicine Associates
Practice address
1805 N Jackson St
BLDG a Suite 100
Tullahoma, TN 37388
Phone
(931) 455-7767
Fax
(931) 455-8636
NPI assigned
Sep 20, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Karla Evans Duncan
Title
Administrator
Phone
(931) 455-7767

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4400309810 TN Primary

Addresses

Primary practice location

1805 N Jackson St
BLDG a Suite 100
Tullahoma, TN 37388

Mailing address

1805 N Jackson St
BLDG a Suite 100
Tullahoma, TN 37388
Phone (931) 455-7767

Other identifiers 3

IdentifierTypeStateIssuer
3724077MedicaidTN
CH1576OtherTNRR MCR
4090988OtherTNBCBS

Other names 1

  • Internal Medicine Associates Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

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": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1811094022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 N JACKSON ST",
            "address_2": "BLDG A SUITE 100",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "37388",
            "telephone_number": "931-455-7767",
            "fax_number": "931-455-8636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 N JACKSON ST",
            "address_2": "BLDG A SUITE 100",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "37388",
            "telephone_number": "931-455-7767",
            "fax_number": "931-455-8636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE ASSOCIATES OF TULLAHOMA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DUNCAN",
        "authorized_official_first_name": "KARLA",
        "authorized_official_middle_name": "EVANS",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "931-455-7767"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "4400309810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3724077",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR",
            "identifier": "CH1576",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4090988",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Internal Medicine Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tullahoma, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.