CEDAR RIDGE CRITICAL CARE MEDICAL GROUP PC (NPI# 1790274850) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790274850 |
| Entity Type | Organization |
| Organization Name | CEDAR RIDGE CRITICAL CARE MEDICAL GROUP PC |
| Practice Address |
651 Dunlop Ln Clarksville TN 37040-5015 |
| Mailing Address |
Po Box 11531 Daytona Beach FL 32120-1531 |
| Practice Telephone | 9315021000 |
| Practice Fax Number | 3862747801 |
| Mailing Telephone | 3862747800 |
| Mailing Fax Number | 3862747801 |
| Enumeration Date | 2018-05-04 |
| Last Update Date | 2018-12-12 |
| Authorized Official Name | STEVEN P MARON (PRESIDENT) |
| Authorized Official Telephone | 9254828233 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
651 DUNLOP LN |
| City | CLARKSVILLE |
| State | TN |
| Zip Code | 37040-5015 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821098690 | Dale P Cunningham | Physical Medicine & Rehabilitation | 651 Dunlop Ln, Clarksville, TN 37040-5015 | 2005-07-22 |
| 1487253183 | Carlyn Alexandra Owens | Physician Assistant | 651 Dunlop Ln, Clarksville, TN 37040-5015 | 2020-10-22 |
| 1427671718 | Clarksville Health System Gp | Medicare Defined Swing Bed Unit | 651 Dunlop Ln, Clarksville, TN 37040-5015 | 2020-05-21 |
| 1063041010 | Caitlynn Richole Laster | Dietitian, Registered | 651 Dunlop Ln, Clarksville, TN 37040-5015 | 2020-04-02 |
| 1457994402 | Caroline Elizabeth Chadwell | Physician Assistant | 651 Dunlop Ln, Clarksville, TN 37040-5015 | 2019-10-22 |
| 1215578976 | Brian Ronald Song | Physician Assistant | 651 Dunlop Ln, Clarksville, TN 37040-5015 | 2019-10-03 |
| 1942768866 | Sabrina Patrise Poydras | Nurse Practitioner | 651 Dunlop Ln, Clarksville, TN 37040-5015 | 2019-03-10 |
| 1780181263 | Allison Bledsoe | Nurse Practitioner | 651 Dunlop Ln, Clarksville, TN 37040-5015 | 2018-04-10 |
| 1528579604 | Valley Emergency Physicians Tennessee PC | Nurse Practitioner | 651 Dunlop Ln, Clarksville, TN 37040-5015 | 2017-10-17 |
| 1730698671 | Mackenzie Zak Rickert | Physician Assistant | 651 Dunlop Ln, Clarksville, TN 37040-5015 | 2017-09-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770124380 | Clarksville Treatment Center, LLC | Clinic/Center | 495 Dunlop Lane, Clarksville, TN 37040 | 2019-10-04 |
| 1295384956 | Dena Marie Borchick | Technician | 3779 Cindy Jo Dr. N, Clarksville, TN 37040 | 2019-09-05 |
| 1477014488 | Emily Allen | Dentist | 930 Hwy 76, Clarksville, TN 37040 | 2019-03-31 |
| 1730640566 | Latoya Ewert | Counselor | Centerstone Clarksville Harriet Cohn Center, 511 8th Street, Clarksville, TN 37040 | 2019-03-26 |
| 1356811988 | Jamie Coles | Behavior Technician | 851 Professional Park Drive 851 Profesiional Park Drive, Clarksville, TN 37040 | 2018-11-27 |
| 1518448554 | Bandel Counseling Service | Clinic/Center | 113 3rd St., Suite 25, Clarksville, TN 37040 | 2018-08-28 |
| 1477052520 | Bridget Stokes | Behavior Technician | 2277 Wilma Rudolph Blvd., Suite C #259, Clarksville, TN 37040 | 2018-02-05 |
| 1053824334 | Sandra Loren Coates | Nurse Practitioner | 980 Professional Park Dr Ste C, Clarksville, TN 37040 | 2017-11-09 |
| 1902328362 | Terri Brooke Roach | Registered Nurse | 651 Dunlop Lane, Clarksville, TN 37040 | 2017-07-07 |
| 1093244428 | Nikkia Deneil Bell | Behavior Technician | 139 E. Old Trenton Rd, Suite B, Clarksville, TN 37040 | 2017-06-08 |
| Find all providers in zip 37040 | ||||
| Taxonomy Code | 207RC0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Critical Care Medicine |
| An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881149995 | Internal & Pulmonary Medicine Associates Pllc | Internal Medicine | 298 Clear Sky Ct, Ste. B, Clarksville, TN 37043-5685 | 2016-08-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477042588 | Victor Kha Do Pllc | Internal Medicine | 397 Wallace Rd Ste 415, Nashville, TN 37211-8028 | 2018-05-03 |
| 1760802938 | David Piskorowski | Internal Medicine | 155 Hospital Rd Ste C, Winchester, TN 37398-2495 | 2014-04-25 |
| 1447679238 | Badar Siddiqui | Internal Medicine | 325 N State of Franklin Road, 2nd Floor, Johnson City, TN 37604 | 2014-04-09 |
| 1134472384 | The Lung Clinic LLC | Internal Medicine | 6019 Walnut Grove Rd., Memphis, TN 38120-0000 | 2012-10-24 |
| 1952667503 | Kimberly Anne Marsh | Internal Medicine | Mid-south Pulmonary Specialists, P.C., 5050 Poplar Ave., Suite 800, Memphis, TN 38157-0800 | 2012-04-09 |
| 1962778167 | Bryan Richard Hay | Internal Medicine | 4320 Harding Pike Ste 503, Nashville, TN 37205 | 2012-04-02 |
| 1154609923 | Jason Wesley Green | Internal Medicine | 1940 Alcoa Hwy Ste 210, Knoxville, TN 37920-2264 | 2011-07-28 |
| 1285869503 | Nathan Eric Wilds | Internal Medicine | 5050 Poplar Ave., Suite 800, Mid-south Pulmonary Specialists, P.C., Memphis, TN 38157 | 2009-05-17 |
| 1598939985 | Jonathan Andrew Kropski | Internal Medicine | 1611 21st Ave S, T1218 Medical Center North, Nashville, TN 37232-0033 | 2008-04-16 |
| 1710019930 | Michael Munday | Internal Medicine | 5050 Poplar Ave Ste 800, Memphis, TN 38157-0800 | 2007-03-12 |
| Find all providers with the same taxonomy | ||||
| City | CLARKSVILLE |
| Zip Code | 37040 |
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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.