Organization Active NPI

Tenn SM, LLC

Doing business as Tennessee Sports Medicine & Orthopaedics

  • Specialist
  • Lebanon, TN
National Provider Identifier
1871775577
Registry record updated Dec 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
TENN SM, LLC
Doing business as
Tennessee Sports Medicine & Orthopaedics
Practice address
1430 W Baddour Pkwy
Lebanon, TN 37087-2514
Phone
(615) 443-7700
Fax
(615) 443-7200
NPI assigned
Dec 4, 2007
Last updated
Dec 4, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2007

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

Authorized official

Name
Dr. Charles Robert Kaelin Jr., M.D.
Title
Owner/MD
Phone
(615) 443-7700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

1430 W Baddour Pkwy
Lebanon, TN 37087-2514

Mailing address

1430 W Baddour Pkwy
Lebanon, TN 37087-2514
Phone (615) 443-7700

Other identifiers 1

IdentifierTypeStateIssuer
3723235OtherGROUP MEDICARE NUMBER

Other names 1

  • Tennessee Sports Medicine & Orthopaedics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Tenn SM LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1196726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196726400000",
    "number": "1871775577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 W BADDOUR PKWY",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370872514",
            "telephone_number": "615-443-7700",
            "fax_number": "615-443-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 W BADDOUR PKWY",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370872514",
            "telephone_number": "615-443-7700",
            "fax_number": "615-443-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TENN SM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-04",
        "last_updated": "2007-12-04",
        "status": "A",
        "authorized_official_last_name": "KAELIN",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER/MD",
        "authorized_official_telephone_number": "615-443-7700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE NUMBER",
            "identifier": "3723235",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tennessee Sports Medicine & Orthopaedics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lebanon, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2007; 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.