CORDOVA MEDICAL & COSMEDIC SOLUTIONS, PC (NPI# 1831229475) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831229475 |
| Entity Type | Organization |
| Organization Name | CORDOVA MEDICAL & COSMEDIC SOLUTIONS, PC |
| Other Organization Name | GERMANTOWN FAMILY PRACTICE, PC |
| Practice Address |
1025 Cordova Station Ave Cordova TN 38018-6318 |
| Mailing Address |
Po Box 4438 Cordova TN 38088-4438 |
| Practice Telephone | 9015074400 |
| Practice Fax Number | 9017565836 |
| Mailing Telephone | 9015074400 |
| Mailing Fax Number | 9017565836 |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2008-01-15 |
| Authorized Official Name | DR. MARC J. CRUPIE (PRESIDENT) |
| Authorized Official Telephone | 9015074400 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
MD15815 | TN | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | BLUE CROSS BLUE SHIELD | 3144579 | 01 |
| Other Name | Type Code |
|---|---|
| Germantown Family Practice, PC | Former Legal Business Name - Organization |
| Street Address |
1025 CORDOVA STATION AVE |
| City | CORDOVA |
| State | TN |
| Zip Code | 38018-6318 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467543140 | Marc J. Crupie | Family Medicine | 1025 Cordova Station Ave, Cordova, TN 38018-6318 | 2006-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588264428 | Shaquia Janai Harris | Behavior Technician | 1079 N Houston Levee Road, Cordova, TN 38018 | 2020-10-29 |
| 1366041493 | Cynthia Brantley | Behavior Technician | 1079 N Houston Levee Rd, Cordova, TN 38018 | 2020-10-20 |
| 1558901736 | At Home Physical Rehabilitation Group, LLC | Physical Therapy Assistant | 856 Willow Tree Circle, Cordova, TN 38018 | 2020-01-15 |
| 1538703038 | Scott Eric Balogh | Psychiatry & Neurology | 65 Germantown Court, Suite 203, Cordova, TN 38018 | 2019-10-29 |
| 1851871305 | Joanna H Fussell | Behavioral Analyst | 8066 Walnut Run Suite 102, Cordova, TN 38018 | 2018-08-15 |
| 1841736097 | A Guardian Care Group | Home Health | 10164 Green Moss, Cordova, TN 38018 | 2017-01-12 |
| 1497127146 | Functional Independence, Inc. | Home Health | 270 German Oak Dr., Memphis, TN 38018 | 2015-10-21 |
| 1679984363 | Tiffany Masters Redfern | Obstetrics & Gynecology | 521 Riveredge Dr W, Cordova, TN 38018 | 2014-05-15 |
| 1295073427 | Mitchell Wyman Alvarez | Optometrist | 2075 N. Germantown Pkwy, Memphis, TN 38018 | 2013-01-23 |
| 1578827531 | Chiung Feng Hsu | Dentist | 831 Timber Creek Dr #1, Cordova, TN 38018 | 2012-06-25 |
| Find all providers in zip 38018 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396018156 | Stone Institute, Inc | Clinic/Center | 8200 Old Dexter Rd, Suite 103, Cordova, TN 38016-0542 | 2012-02-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780281527 | Braxton Medical Clinic, LLC | Clinic/Center | 1410 Kensington Square Ct Ste 103, Murfreesboro, TN 37130-6902 | 2020-10-05 |
| 1629689674 | Saint Thomas Medical Partners | Clinic/Center | 220 West Jefferson Pike, Murfreesboro, TN 37129 | 2020-08-13 |
| 1700411592 | Fentress Family Care LLC | Clinic/Center | 1010 Old Highway 127 S, Jamestown, TN 38556-5648 | 2020-03-11 |
| 1831724822 | Guiding Star Memphis | Clinic/Center | 2980 Poplar Ave Ste 101, Memphis, TN 38111-3527 | 2020-03-10 |
| 1407486764 | Elijahs Dream Compassionate Care | Clinic/Center | 134 Creekside Dr Ste 1, Ocoee, TN 37361-3653 | 2020-01-24 |
| 1518506542 | Faith Medical Group, Pllc | Clinic/Center | 500 Mcfarland St Ste E, Morristown, TN 37814-3992 | 2019-12-20 |
| 1366080582 | Matthew E. Schantz, M.d. | Clinic/Center | 206 S Military St Ste 1, Loretto, TN 38469-2101 | 2019-12-18 |
| 1114563749 | Step One Medical Associates PC | Clinic/Center | 4502 Bristol Hwy, Johnson City, TN 37601-2936 | 2019-11-19 |
| 1023665403 | Elite Healthcare, LLC | Clinic/Center | 117 N 3rd St, Kingston, TN 37763-2842 | 2019-08-21 |
| 1083266381 | Get Into Shape Md | Clinic/Center | 5803 Lee Hwy Ste 101, Chattanooga, TN 37421-3547 | 2019-07-16 |
| Find all providers with the same taxonomy | ||||
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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.