Organization Active NPI

Mashburn Family Health, PLLC

  • Primary Care Clinic/Center
  • Pulaski, TN
National Provider Identifier
1861162430
Registry record updated Feb 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
MASHBURN FAMILY HEALTH, PLLC
Practice address
1102 E College St
Pulaski, TN 38478-4519
Phone
(931) 300-0534
NPI assigned
Sep 15, 2021
Last updated
Feb 21, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2024

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

Authorized official

Name
Steven N Mashburn, NPNPI 1942373717
Title
NP/Owner
Phone
(931) 371-9500

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

1102 E College St
Pulaski, TN 38478-4519

Mailing address

1102 E College St
Pulaski, TN 38478-4519
Phone (931) 371-9500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211229002489 TN Part B Supplier - Clinic/Group Practice 9638560600 Receives reassigned benefits from 1 practitioner
Practice locations: Pulaski, TN

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D2250374Mashburn Family Health1102 E College Street, Pulaski, TN 38478Certificate of waiverJan 25, 2028

National Provider Directory

National Provider Directory

Locations

1102 E College St
Pulaski, TN 38478
Phone (931) 300-0534

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24818/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 1

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": "1631664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708473600000",
    "number": "1861162430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 E COLLEGE ST",
            "city": "PULASKI",
            "state": "TN",
            "postal_code": "384784519",
            "telephone_number": "931-371-9500",
            "fax_number": "629-200-0329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 E COLLEGE ST",
            "city": "PULASKI",
            "state": "TN",
            "postal_code": "384784519",
            "telephone_number": "931-300-0534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASHBURN FAMILY HEALTH, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-15",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A",
        "authorized_official_last_name": "MASHBURN",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "NP/OWNER",
        "authorized_official_telephone_number": "931-371-9500",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pulaski, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2024; 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.