Provider Demographics
NPI:1639360860
Name:OCCUPATIENT MEDICAL SERVICES, P.C.
Entity Type:Organization
Organization Name:OCCUPATIENT MEDICAL SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RENATA
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:BLUHM
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:615-316-0100
Mailing Address - Street 1:5651 FRIST BOULEVARD
Mailing Address - Street 2:SUITE 306
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076
Mailing Address - Country:US
Mailing Address - Phone:615-316-0100
Mailing Address - Fax:615-872-0088
Practice Address - Street 1:5651 FRIST BOULEVARD
Practice Address - Street 2:SUITE 306
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076
Practice Address - Country:US
Practice Address - Phone:615-316-0100
Practice Address - Fax:615-872-0088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-05
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD19042207R00000X, 2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3036293Medicaid
150738OtherBLUE CROSS BLUE SHIELD
3036293OtherMEDICARE LEGACY #3036293
3036293OtherMEDICARE LEGACY #3036293
=========OtherCIGNA
=========OtherUNITED HEALTHCARE