Coffee County Internal Medicine,PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

39341 Issued in TN

Legal business name

COFFEE COUNTY INTERNAL MEDICINE,PC

Practice address

1330 Cedar LN
Suite 1200
Tullahoma, TN 37388-2283

Phone

(931) 454-9090

Fax

(931) 454-0773

NPI assigned

Dec 27, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Dinesh Agnihotri, M.D.NPI 1932186723

Title

President

Phone

(931) 454-9090

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dinesh Agnihotri, MD

  • Internal Medicine Physician
  • Fort Wayne, IN
  • NPI 1932186723
  NPD (past) Authorized official

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

{
    "created_epoch": "1198713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198800000000",
    "number": "1942484787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 157",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373880157",
            "telephone_number": "931-454-9090",
            "fax_number": "931-454-0773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 CEDAR LN",
            "address_2": "SUITE 1200",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373882283",
            "telephone_number": "931-454-9090",
            "fax_number": "931-454-0773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COFFEE COUNTY INTERNAL MEDICINE,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-27",
        "last_updated": "2007-12-28",
        "status": "A",
        "authorized_official_last_name": "AGNIHOTRI",
        "authorized_official_first_name": "DINESH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "931-454-9090",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "39341",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3728587",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "3728587",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristina Chung, MD
• Sharon Renee Cicero, CRNA
• Jeanetta Clark
• Mia Jones Clermont, APRN, RN
• Susan Clower
• Coffee County Senior Citizens, Inc
• Lori Coffman
• Richard Clinton Cole, MD
• Robert Craig Collier, MD
• Suzanne Chamblee Collier, MD

• Internal Medicine Physician in Tullahoma, TN
• Providers in Tullahoma, TN by specialty
• Internal Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 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.