NPIMap

Organization Active NPI

Amg - Southern Tennessee, LLC

  • Family Medicine Physician
  • Winchester, TN
National Provider Identifier
1982988820
Registry record updated Oct 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
AMG - SOUTHERN TENNESSEE, LLC
Practice address
186 Hospital Rd
Suite 300
Winchester, TN 37398-2472
Phone
(931) 967-2520
NPI assigned
Oct 10, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2011

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

Authorized official

Name
Daniel Sykes
Title
Vice President
Phone
(615) 372-8500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

186 Hospital Rd
Suite 300
Winchester, TN 37398-2472

Mailing address

186 Hospital Rd
Suite 300
Winchester, TN 37398-2472
Phone (931) 967-2520

Other names 1

  • Wellstream Family Medicine Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041013001206 TN Part B Supplier - Clinic/Group Practice 5991765943 Receives reassigned benefits from 112 practitioners
41 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Tullahoma, TN; Winchester, TN; Decherd, TN; Estill Springs, TN; Fayetteville, TN; Huntland, TN; Lawrenceburg, TN; Lynchburg, TN…

Other NPIs on the same Medicare enrollment 41

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 41

National Provider Directory

National Provider Directory

Locations

186 Hospital Rd
Ste 300
Winchester, TN 37398
Phone (931) 967-2520

187 Hospital Rd
Winchester, TN 37398

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1318204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318464000000",
    "number": "1982988820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "186 HOSPITAL RD",
            "address_2": "SUITE 300",
            "city": "WINCHESTER",
            "state": "TN",
            "postal_code": "373982472",
            "telephone_number": "931-967-2520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "186 HOSPITAL RD",
            "address_2": "SUITE 300",
            "city": "WINCHESTER",
            "state": "TN",
            "postal_code": "373982472",
            "telephone_number": "931-967-2520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMG - SOUTHERN TENNESSEE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-10",
        "last_updated": "2011-10-13",
        "status": "A",
        "authorized_official_last_name": "SYKES",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "615-372-8500"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wellstream Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Winchester, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.