Provider Demographics
NPI:1578868212
Name:HARPETH FAMILY MEDICINEPC
Entity Type:Organization
Organization Name:HARPETH FAMILY MEDICINEPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MD
Authorized Official - Prefix:
Authorized Official - First Name:SRINIVAS
Authorized Official - Middle Name:
Authorized Official - Last Name:NIMMAGADDA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-309-0080
Mailing Address - Street 1:8115 ISABELLA LN
Mailing Address - Street 2:SUITE 12
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-9109
Mailing Address - Country:US
Mailing Address - Phone:615-309-0080
Mailing Address - Fax:615-932-7270
Practice Address - Street 1:8115 ISABELLA LN
Practice Address - Street 2:SUITE 12
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-9109
Practice Address - Country:US
Practice Address - Phone:615-309-0080
Practice Address - Fax:615-932-7270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-11
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000041393207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty