NPIMap

Organization Active NPI

Centennial Surgical Clinic, LLC

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Nashville, TN
National Provider Identifier
1992009500
Registry record updated Mar 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
Legal business name
CENTENNIAL SURGICAL CLINIC, LLC
Practice address
2400 Patterson St Ste 215
Nashville, TN 37203-6501
Phone
(615) 342-7345
NPI assigned
Dec 23, 2010
Last updated
Mar 23, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2023

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

Authorized official

Name
Louis Joseph
Title
Vice President
Phone
(615) 373-7600

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Nurse Practitioner 363L00000X NU
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X NU Primary

Addresses

Primary practice location

2400 Patterson St Ste 215
Nashville, TN 37203-6501

Mailing address

2000 Health Park Dr
Brentwood, TN 37027-4692
Phone (615) 373-7406

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110328000093 TN Part B Supplier - Clinic/Group Practice 6800079963 Receives reassigned benefits from 19 practitioners
Practice locations: Nashville, TN; Smyrna, TN; Spring Hill, TN; Manchester, TN; Hermitage, TN; Dickson, TN; Columbia, TN

National Provider Directory

National Provider Directory

Member of 1

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

Locations

315 N Washington Ave
#239
Cookeville, TN 38501

111 Highway 70 E
#G
Dickson, TN 37055

113 Highway 70 E
Ste 104
Dickson, TN 37055

5653 Frist Blvd
Ste 239
Hermitage, TN 37076
Phone (615) 232-8812

2933 Medical Center Pkwy
Ste D8
Murfreesboro, TN 37129

2400 Patterson St
#212
Nashville, TN 37203

2400 Patterson St
Ste 400
Nashville, TN 37203
Phone (615) 342-5941

2400 Patterson St
Ste 418
Nashville, TN 37203
Phone (615) 342-5964

335 24th Ave N
Ste 120
Nashville, TN 37203
Phone (615) 342-0290

300 Stonecrest Blvd
Ste 420F
Smyrna, TN 37167

3001 Reserve Blvd
Ste 208
Spring Hill, TN 37174

Practitioners & affiliated clinicians

Practitioners 35

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 35

NPI Registry JSON

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

{
    "created_epoch": "1293062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679529600000",
    "number": "1992009500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 HEALTH PARK DR",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274692",
            "telephone_number": "615-373-7406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 PATTERSON ST STE 215",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372036501",
            "telephone_number": "615-342-7345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTENNIAL SURGICAL CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-23",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A",
        "authorized_official_last_name": "JOSEPH",
        "authorized_official_first_name": "LOUIS",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "615-373-7600"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2023; 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.