Organization Active NPI

Cumberland Radiology Group PC

  • Diagnostic Radiology Physician
  • Crossville, TN
National Provider Identifier
1962510529
Registry record updated Mar 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
CUMBERLAND RADIOLOGY GROUP PC
Practice address
421 S Main St
Crossville, TN 38555-5048
Phone
(931) 484-9511
NPI assigned
Aug 25, 2006
Last updated
Mar 16, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2012

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

Authorized official

Name
James Stallworth
Title
President
Phone
(931) 484-0048

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X NU Primary

Addresses

Primary practice location

421 S Main St
Crossville, TN 38555-5048

Mailing address

PO Box 3139
Crossville, TN 38557-3139
Phone (931) 484-0048

Other identifiers 3

IdentifierTypeStateIssuer
3386332MedicaidTN
CC1089OtherRR MEDICARE
1962510529OtherNPI

National Provider Directory

National Provider Directory

Locations

36 Fourth St
Crossville, TN 38555
Phone (615) 484-0048

Practitioners & affiliated clinicians

Practitioners 2

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": "1156464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331856000000",
    "number": "1962510529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3139",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385573139",
            "telephone_number": "931-484-0048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 S MAIN ST",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385555048",
            "telephone_number": "931-484-9511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUMBERLAND RADIOLOGY GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-25",
        "last_updated": "2012-03-16",
        "status": "A",
        "authorized_official_last_name": "STALLWORTH",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "931-484-0048"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3386332",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CC1089",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1962510529",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crossville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2012; 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.