MID-STATE UROLOGY PC (NPI# 1417252594) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417252594 |
| Entity Type | Organization |
| Organization Name | MID-STATE UROLOGY PC |
| Other Organization Name | MID-SOUTH PEDIATRIC UROLOGY PC |
| Practice Address |
329 21st Ave N Suite 2 Nashville TN 37203-1839 |
| Practice Telephone | 6153210481 |
| Practice Fax Number | 6153215649 |
| Mailing Telephone | 6153210481 |
| Mailing Fax Number | 6153215649 |
| Enumeration Date | 2011-01-20 |
| Last Update Date | 2011-01-20 |
| Authorized Official Name | DR. HERBERT VICTOR BRAREN (PRESIDENT) |
| Authorized Official Telephone | 6153210481 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2088P0231X |
Urology Specialization: Pediatric Urology |
Allopathic & Osteopathic Physicians | ||
| Y | 208800000X | Urology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Mid-South Pediatric Urology PC | Former Legal Business Name - Organization |
| Street Address |
329 21ST AVE N SUITE 2 |
| City | NASHVILLE |
| State | TN |
| Zip Code | 37203-1839 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760485817 | Sam Houston Moran | Obstetrics & Gynecology | 329 21st Ave N, Ste 4, Nashville, TN 37203-1838 | 2005-05-23 |
| 1801293808 | Jenna Bletzacker | Nurse Practitioner | 329 21st Ave N, Suite 4, Nashville, TN 37203-1839 | 2014-11-19 |
| 1225049802 | Green Hills Health & Wellness Inc | Pharmacy | 329 21st Ave N, Ste 3, Nashville, TN 37203-1839 | 2006-08-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265031843 | Results-ast Jv, LLC | Physical Therapist | 1000 Church Street, Nashville, TN 37203 | 2020-10-23 |
| 1922607159 | Results-ast Jv, LLC | Physical Therapist | 222 22nd Avenue North, Suite 100, Nashville, TN 37203 | 2020-10-19 |
| 1427663152 | Amber Nicole Fox | Nurse Practitioner | 2300 Patterson Street-endo Dept, Nashville, TN 37203 | 2020-09-10 |
| 1144839648 | Tasha Yarris | Nurse Practitioner | 412 Dr D.b. Todd Jr Blvd., Nashville, TN 37203 | 2020-07-30 |
| 1013536655 | Colby Wollenman | Student in an Organized Health Care Education/Training Program | Vanderbilt Orthopaedic Institute 1215 21st Ave S, Medical Center East, South Tower, Suite 4200, Nashville, TN 37203 | 2020-04-14 |
| 1477193738 | Ames Center for Counseling LLC | Social Worker | 1900 Church Street #300, Nashville, TN 37203 | 2020-01-14 |
| 1750922498 | Lisa Michelle Gregory Beck | Nurse Practitioner | 2221 Murphy Avenue, Nashville, TN 37203 | 2019-10-03 |
| 1235634023 | Jackson Primary Care | Family Medicine | 2010 Church St Ste 526, Nashville, TN 37203 | 2018-03-26 |
| 1932614237 | Caitlin Butcher | Social Worker | 402 22nd Ave North, Nashville, TN 37203 | 2017-12-08 |
| 1780194068 | Casey Lynn O'quinn | Behavioral Analyst | 2108 Hayes St, Nashville, TN 37203 | 2017-10-02 |
| Find all providers in zip 37203 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396363875 | Connor Forbes | Urology | Vumc Dept Urology, 1161 21st Ave. South, A-1302 Medical Center North, Nashville, TN 37232-2765 | 2020-07-10 |
| 1932625662 | Urology Associates PC | Urology | 393 Wallace Rd Ste A400, Nashville, TN 37211-4983 | 2017-08-15 |
| 1124544853 | Urology Associates PC | Urology | 3443 Dickerson Pike Ste 160, Nashville, TN 37207-2533 | 2017-08-15 |
| 1629598453 | Female Physicians of Tennessee, P.C. | Urology | 310 25th Ave N Ste 202, Nashville, TN 37203-1515 | 2017-06-22 |
| 1467865907 | Anne Darves-bornoz | Urology | Department of Urologic Surgery, A-1302 Medical Center North, Vanderbilt University, Nashville, TN 37232-2765 | 2014-06-03 |
| 1255775581 | Miguel Gosalbez | Urology | 1161 21st Ave S # A-1302, Vanderbilt University Medical Center, Nashville, TN 37232-0011 | 2013-04-17 |
| 1720421886 | Matthew Elliott Pollard | Urology | 4230 Harding Pike Ste 521, Nashville, TN 37205-4900 | 2013-04-09 |
| 1740301712 | Gregory Daniel Head | Urology | 3443 Dickerson Pike Suite 160, Nashville, TN 37207 | 2007-04-03 |
| 1487710893 | Matthew Jason Resnick | Urology | Vanderbilt Department of Urologic Surgery, A-1302 Medical Center North, Nashville, TN 37232-0001 | 2006-12-29 |
| 1861589970 | Harriette M Scarpero | Urology | 4230 Harding Rd Ste 521, Nashville, TN 37205-4900 | 2006-10-09 |
| Find all providers in NASHVILLE | ||||
Please comment or provide details below to improve the information on MID-STATE UROLOGY PC.
| 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.