Provider Demographics
NPI:1659487494
Name:CHILDREN AND ADULTS MEDICAL GROUP, LLC
Entity Type:Organization
Organization Name:CHILDREN AND ADULTS MEDICAL GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:H
Authorized Official - Last Name:SCHATZLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-284-7847
Mailing Address - Street 1:PO BOX 24730
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37202-4730
Mailing Address - Country:US
Mailing Address - Phone:615-222-3331
Mailing Address - Fax:
Practice Address - Street 1:4220 HARDING RD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2005
Practice Address - Country:US
Practice Address - Phone:615-222-3331
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2014-10-01
Deactivation Date:2014-07-11
Deactivation Code:
Reactivation Date:2014-10-01
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY65946378Medicaid
KY7100164310Medicaid
TN3374470Medicaid
TN3374470Medicare PIN