Jerald C Gifford

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

PRO77, ORT99 Issued in TN

Legal business name

JERALD C GIFFORD

Practice address

1411 Mark Allen LN Ste C
Murfreesboro, TN 37129-5556

Phone

(615) 809-2650

Fax

(615) 410-7392

NPI assigned

Jan 18, 2017

Organization subpart

No

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

Authorized official

Name

Jerald Craig Gifford, CPO, LPO

Title

Owner

Phone

(615) 809-2650

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 2

• Middle Tennessee O&P Doing business as
• Middle Tennessee Orthotics & Prosthetics Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1484697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601856000000",
    "number": "1851837686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 MARK ALLEN LN STE C",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371295556",
            "telephone_number": "615-809-2650",
            "fax_number": "615-410-7392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 MARK ALLEN LN STE C",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371295556",
            "telephone_number": "615-809-2650",
            "fax_number": "615-410-7392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERALD C GIFFORD",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-18",
        "last_updated": "2020-10-05",
        "certification_date": "2020-10-05",
        "status": "A",
        "authorized_official_last_name": "GIFFORD",
        "authorized_official_first_name": "JERALD",
        "authorized_official_middle_name": "CRAIG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "615-809-2650",
        "authorized_official_credential": "CPO, LPO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "TN",
            "license": "PRO77, ORT99",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q035307",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Craig@middletnoanp.net",
            "affiliation": "N",
            "endpointDescription": "Google G Suite",
            "address_1": "1411 Mark Allen Ln Ste C",
            "city": "Murfreesboro",
            "state": "TN",
            "country_code": "US",
            "postal_code": "371295556",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Middle Tennessee O&P",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Middle Tennessee O&P",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Middle Tennessee Orthotics & Prosthetics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jessica Jenkins
• Kelly Renae Jenkins, CRNA
• Leah Mari-Ann Jenkins
• Manda Jennings
• James Jensen
• Hannah Jernigan
• Tiffany Jenna Jernigan, DPT
• Jessica Ashley, LPC-MHSP
• Marva Lee Jeub
• Shyam A Jha, M.D.

• Prosthetic/Orthotic Supplier in Murfreesboro, TN
• Providers in Murfreesboro, TN by specialty
• Prosthetic/Orthotic Supplier in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.