Signature Medical Laboratory

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

SIGNATURE MEDICAL LABORATORY

Practice address

1097 Weston Dr
Suite 1
Mount Juliet, TN 37122-3493

Phone

(615) 758-4601

Fax

(615) 754-7074

NPI assigned

Dec 1, 2009

Organization subpart

No

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

Authorized official

Name

Darrell D Tidwell

Title

President

Phone

(615) 758-4601

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Joseph E Brown, DDS

  • General Practice Dentistry
  • Mt Juliet, TN
  • NPI 1780972554
  NPD (past)

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

{
    "created_epoch": "1259625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268179200000",
    "number": "1831427962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 SIGNATURE PL",
            "address_2": "SUITE 104",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370873376",
            "telephone_number": "615-444-7999",
            "fax_number": "615-444-7765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1097 WESTON DR",
            "address_2": "SUITE 1",
            "city": "MOUNT JULIET",
            "state": "TN",
            "postal_code": "371223493",
            "telephone_number": "615-758-4601",
            "fax_number": "615-754-7074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIGNATURE MEDICAL LABORATORY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-01",
        "last_updated": "2010-03-10",
        "status": "A",
        "authorized_official_last_name": "TIDWELL",
        "authorized_official_first_name": "DARRELL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-758-4601"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan Ashley Shiflett, LPC-MHSP
• Kelly Short, O.D.
• Raquel Jackson Shutze, LPC-MHSP
• William Siegel, D.C.
• Rebekah Siers, RBT
• Allison Simmel, DPT
• Jayme Simmons
• Simply Smiles, PLLC
• Melanie Singeltary
• Jennifer D Sircy

• Clinical Medical Laboratory in Mount Juliet, TN
• Providers in Mount Juliet, TN by specialty
• Clinical Medical Laboratory in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2010; 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.