NPIMap

Organization Active NPI

Vanderbilt Integrated Providers, LLC

Doing business as Vanderbilt Integrated Providers

  • Family Medicine Physician
  • Tullahoma, TN
National Provider Identifier
1982625091
Registry record updated Sep 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
VANDERBILT INTEGRATED PROVIDERS, LLC
Doing business as
Vanderbilt Integrated Providers
Practice address
1440 Cedar LN
Tullahoma, TN 37388-2485
Phone
(615) 393-7056
NPI assigned
Jul 22, 2006
Last updated
Sep 16, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2026

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

Authorized official

Name
Wendy Monaci
Title
Vice President
Phone
(615) 936-3944

Specialties & licenses 13

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Nurse Practitioner 363L00000X
Family Nurse Practitioner 363LF0000X
Pediatric Nurse Practitioner 363LP0200X
Advanced Practice Midwife 367A00000X
Emergency Medicine Physician 207P00000X
Family Medicine Physician 207Q00000X Primary
Internal Medicine Physician 207R00000X
Obstetrics & Gynecology Physician 207V00000X
Orthopaedic Surgery Physician 207X00000X
Pediatrics Physician 208000000X
Surgery Physician 208600000X
Hospitalist Physician 208M00000X

Addresses

Primary practice location

1440 Cedar LN
Tullahoma, TN 37388-2485

Mailing address

3841 Green Hills Village Dr Ste 200
Nashville, TN 37215-2691

Other practice location 1

1161 21st Ave S
Nashville, TN 37232-9339
Phone (615) 322-5000

Other practice location 2

4235 Fort Campbell Blvd
Hopkinsville, KY 42240-9339
Phone (270) 885-8445

Other identifiers 2

IdentifierTypeStateIssuer
Q063257MedicaidTN
65932329MedicaidKY

Other names 1

  • Vanderbilt Integrated Providers Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040108001021 TN Part B Supplier - Clinic/Group Practice 7012817919 Receives reassigned benefits from 165 practitioners
Practice locations: Shelbyville, TN; Tullahoma, TN; Manchester, TN; Lebanon, TN; Clarksville, TN; Brentwood, TN
O20050225000278 KY Part B Supplier - Clinic/Group Practice 7012817919 Receives reassigned benefits from 5 practitioners
Practice locations: Hopkinsville, KY

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Member of 19

Organizations this organization is a member of, according to the National Provider Directory.

View all 19

Locations

1616 W Main St
Ste 201
Lebanon, TN 37087
Phone (615) 443-6834

120 Frank Martin Rd
Shelbyville, TN 37160
Phone (931) 684-3040

1440 Cedar Ln
Ste 100
Tullahoma, TN 37388
Phone (931) 393-7060

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Vip Children's Clinic-LafayetteLafayette, TN, CCN 883850 Rural health clinic 5% Or Greater Indirect Ownership Interest Jul 1, 1998
Vip Children's Clinic - SpringfieldSpringfield, TN, CCN 883849 Rural health clinic Limited Partnership Interest Jul 1, 1998
Vip Childrens Clinic-Pleasant ViewPleasant View, TN, CCN 883848 Rural health clinic Limited Partnership Interest Jul 1, 1998

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • Vip Midsouth, LLC

    dba VIP Children's Clinic - Pleasant View

    • Rural Health Clinic/Center
    • Pleasant View, TN
    • NPI 1336722669

    Limited Partnership Interest

    CMS ownership
  • Vip Midsouth, LLC

    dba VIP Children's Clinic - Springfield

    • Rural Health Clinic/Center
    • Springfield, TN
    • NPI 1528641859

    Limited Partnership Interest

    CMS ownership
  • Vip Midsouth, LLC

    dba VIP Children's Clinic - Lafayette

    • Rural Health Clinic/Center
    • Lafayette, TN
    • NPI 1588247811

    5% Or Greater Indirect Ownership Interest

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 202

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.

View all 202

NPI Registry JSON

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789516800000",
    "number": "1982625091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3841 GREEN HILLS VILLAGE DR STE 200",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372152691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 CEDAR LN",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373882485",
            "telephone_number": "615-393-7056"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1161 21st Ave S",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372329339",
            "country_code": "US",
            "telephone_number": "615-322-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4235 Fort Campbell Blvd",
            "address_purpose": "LOCATION",
            "city": "Hopkinsville",
            "state": "KY",
            "postal_code": "422409339",
            "country_code": "US",
            "telephone_number": "270-885-8445",
            "fax_number": "270-886-9106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VANDERBILT INTEGRATED PROVIDERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2026-09-16",
        "certification_date": "2026-09-16",
        "status": "A",
        "authorized_official_last_name": "MONACI",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "615-936-3944"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q063257",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65932329",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vanderbilt Integrated Providers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tullahoma, TN

Sources for this page

Verify at the official NPI Registry.