NPIMap

Organization Active NPI

Lebanon Health Care Center

  • Family Medicine Physician
  • Lebanon, TN
National Provider Identifier
1902905573
Registry record updated Sep 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
7162 Issued in TN
Legal business name
LEBANON HEALTH CARE CENTER
Practice address
307 F West Main St
Lebanon, TN 37087
Phone
(615) 449-4151
Fax
(615) 449-1994
NPI assigned
Sep 21, 2006
Last updated
Sep 30, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2008

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

Authorized official

Name
Tyroma Denise Hendrix, DC
Title
Owner Doctor
Phone
(615) 504-9735

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1192PA TN
Chiropractor 111N00000X 1874DC TN
Family Medicine Physician 207Q00000X 7162 TN Primary

Addresses

Primary practice location

307 F West Main St
Lebanon, TN 37087

Mailing address

307 F West Main St
PO Box 3322
Lebanon, TN 37087
Phone (615) 449-4151

Other identifiers 1

IdentifierTypeStateIssuer
P4110444OtherTNBCBS

Other names 1

  • Lebanon Pain Management Clinic Former legal business name

National Provider Directory

National Provider Directory

Locations

1123 N Castle Heights Ave
Ste G
Lebanon, TN 37087
Phone (615) 449-4151

Practitioners & affiliated clinicians

Practitioners 5

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": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222732800000",
    "number": "1902905573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 F WEST MAIN ST",
            "address_2": "PO BOX 3322",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "37087",
            "telephone_number": "615-449-4151",
            "fax_number": "615-449-1994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 F WEST MAIN ST",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "37087",
            "telephone_number": "615-449-4151",
            "fax_number": "615-449-1994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEBANON HEALTH CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2008-09-30",
        "status": "A",
        "authorized_official_last_name": "HENDRIX",
        "authorized_official_first_name": "TYROMA",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "OWNER DOCTOR",
        "authorized_official_telephone_number": "615-504-9735",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "1192PA",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "1874DC",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "7162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "P4110444",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lebanon Pain Management Clinic",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Sep 30, 2008; 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.