MID-STATE SPORTS MEDICINE (NPI# 1063606655) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063606655 |
| Entity Type | Organization |
| Organization Name | MID-STATE SPORTS MEDICINE |
| Practice Address |
221 N Oak Ave Cookeville TN 38501-2437 |
| Practice Telephone | 9315256676 |
| Practice Fax Number | 9315256689 |
| Mailing Telephone | 9315256676 |
| Mailing Fax Number | 9315256689 |
| Enumeration Date | 2007-08-28 |
| Last Update Date | 2007-08-28 |
| Authorized Official Name | DR. RICHARD I WILLIAMS (OWNER) |
| Authorized Official Telephone | 9315256676 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | MD27426 | TN | Allopathic & Osteopathic Physicians |
| Street Address |
221 N OAK AVE |
| City | COOKEVILLE |
| State | TN |
| Zip Code | 38501-2437 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588645196 | Pardeep K Sharma | Family Medicine | 221 N Oak Ave, Cookeville, TN 38501-2437 | 2005-11-10 |
| 1265057855 | Tn Lung and Sleep Center LLC | Internal Medicine | 221 N Oak Ave, Cookeville, TN 38501-2437 | 2020-06-10 |
| 1457737728 | Rajiv Sinanan | Internal Medicine | 221 N Oak Ave, Cookeville, TN 38501-2437 | 2015-08-10 |
| 1891059408 | Virin Rajiv Neil Ramoutar | Internal Medicine | 221 N Oak Ave, Cookeville, TN 38501-2437 | 2012-06-28 |
| 1649290404 | Vijay A Rupanagudi | Internal Medicine | 221 N Oak Ave, Cookeville, TN 38501-2437 | 2006-07-21 |
| 1578533105 | Anju Mendiratta | Specialist | 221 N Oak Ave, Cookeville, TN 38501-2437 | 2006-01-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811596711 | Results-ast Jv, LLC | Physical Therapist | 627 James Campbell Blvd, South, Suite B, Columbia, TN 38501 | 2020-10-21 |
| 1376167080 | Melinda Jane Jetter | Registered Nurse | 320 North Willow Avenue, Cookeville, TN 38501 | 2020-05-29 |
| 1366950875 | Tara Beth Smith | Occupational Therapist | 315 N Washington Ave Ste 240, Cookeville, TN 38501 | 2018-01-18 |
| 1669990339 | Tonya Rachelle Perry | Counselor | 13 South Jefferson Ave, Cookeville, TN 38501 | 2017-09-01 |
| 1659896207 | Dustin Chase Rich | Physical Therapist | 105 S. Willow Ave, #100, Cookeville, TN 38501 | 2017-08-04 |
| 1487009668 | Holly Young | Physical Therapist | 315 North Washungton Ave., Suite 240, Cookeville, TN 38501 | 2016-04-26 |
| 1194190306 | Johnna Sprague | Nurse Practitioner | 620 S. Jefferson Ave, Suite 202, Cookeville, TN 38501 | 2015-12-14 |
| 1881099885 | Carlos Alberto Podesta | Internal Medicine | 238 W 4th St Ste 200, Cookeville, TN 38501 | 2014-11-03 |
| 1124445002 | Shashank Sarvepalli | Internal Medicine | 1 Medical Center Blvd Ste D, Cookeville, TN 38501 | 2014-03-27 |
| 1689095762 | Kendra Hicks | Licensed Practical Nurse | 701 County Services Drive, Cookeville, TN 38501 | 2013-12-17 |
| Find all providers in zip 38501 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881936292 | Sam Taylor Barnes | Orthopaedic Surgery | 1301 Holladay Rd, Cookeville, TN 38501-4645 | 2013-03-23 |
| 1356344782 | James Byron Talmage | Orthopaedic Surgery | 315 N Washington Ave, Ste 165, Cookeville, TN 38501-2623 | 2005-05-31 |
| 1831430818 | Shawn Paul Stachler | Orthopaedic Surgery | 105 S Willow Ave, Cookeville, TN 38501-4667 | 2013-03-15 |
| 1407887870 | Philip A Elizondo | Orthopaedic Surgery | 105 S Willow Ave, Cookeville, TN 38501-3138 | 2006-07-05 |
| 1194712919 | James D Mckinney | Orthopaedic Surgery | 105 S Willow Ave, Cookeville, TN 38501-3138 | 2005-10-06 |
| 1669469722 | Carl M Hollmann | Orthopaedic Surgery | 105 S Willow Ave, Cookeville, TN 38501-3138 | 2005-10-04 |
| 1043207574 | Gregory J Roberts | Orthopaedic Surgery | 105 S Willow Ave, Cookeville, TN 38501-3138 | 2005-09-30 |
| 1588651145 | John M Turnbull | Orthopaedic Surgery | 105 S Willow Ave, Cookeville, TN 38501-3138 | 2005-09-29 |
| 1467452771 | John Keith Nichols | Orthopaedic Surgery | 105 S Willow Ave, Cookeville, TN 38501-3138 | 2005-07-28 |
| 1902804198 | Kenneth A Grinspun | Orthopaedic Surgery | 105 S Willow Ave, Cookeville, TN 38501-4667 | 2005-07-12 |
| Find all providers in COOKEVILLE | ||||
| City | COOKEVILLE |
| Zip Code | 38501 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.