Individual provider Active NPI

Jonathan Scott Huitink, MD

  • Pediatrics Physician
  • Gallatin, TN
National Provider Identifier
1881671097
Registry record updated Dec 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
49558 Issued in TN
Practice address
648 Hartsville Pike
Gallatin, TN 37066-2523
Phone
(615) 451-9246
Fax
(615) 452-9410
NPI assigned
Dec 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 49558 TN Primary

Addresses

Primary practice location

648 Hartsville Pike
Gallatin, TN 37066-2523

Mailing address

648 Hartsville Pike
Gallatin, TN 37066-2523
Phone (615) 451-9246

Other identifiers 4

IdentifierTypeStateIssuer
00N59XOtherTXMEDICARE GROUP #
00N59XOtherTXBCBS OF TX - GROUP #
084249401OtherTXMEDICAID GROUP #
197648202MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170127001759 TN Practitioner - Pediatric Medicine 3476612797 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Diagnostic Imaging PC CurrentSince Jul 1, 2019 Accepting new patients
Advanced Diagnostic Imaging, PC CurrentSince Jul 1, 2019 Accepting new patients
Hillcrest Family Health Center Pediatrics PastSince Oct 23, 2017 Accepting new patients
Privia Medical Group Tennessee LLC Pediatrics Past Accepting new patients

Locations

879 Greenlea Blvd
Ste 103
Gallatin, TN 37066
Phone (615) 461-0656

3443 Dickerson Pike
Ste 400
Nashville, TN 37207
Phone (615) 612-2146

300 Stonecrest Blvd
Ste 220
Smyrna, TN 37167
Phone (615) 459-4441

Interoperability endpoints

  • Direct secure messaging: jonathan.huitink.1@25094.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480550400000",
    "number": "1881671097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "648 HARTSVILLE PIKE",
            "city": "GALLATIN",
            "state": "TN",
            "postal_code": "370662523",
            "telephone_number": "615-451-9246",
            "fax_number": "615-452-9410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "648 HARTSVILLE PIKE",
            "city": "GALLATIN",
            "state": "TN",
            "postal_code": "370662523",
            "telephone_number": "615-451-9246",
            "fax_number": "615-452-9410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUITINK",
        "first_name": "JONATHAN",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-29",
        "last_updated": "2016-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "49558",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP #",
            "identifier": "00N59X",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TX - GROUP #",
            "identifier": "00N59X",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP #",
            "identifier": "084249401",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "197648202",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gallatin, TN

Sources for this page

Verify at the official NPI Registry.