Provider Demographics
NPI:1922415173
Name:URGENT TEAM MANAGEMENT LLC
Entity Type:Organization
Organization Name:URGENT TEAM MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING DIR
Authorized Official - Prefix:
Authorized Official - First Name:WANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-988-2014
Mailing Address - Street 1:30 BURTON HILLS BLVD STE 175
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-6403
Mailing Address - Country:US
Mailing Address - Phone:615-988-2014
Mailing Address - Fax:615-301-6550
Practice Address - Street 1:30 BURTON HILLS BLVD STE 175
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215-6403
Practice Address - Country:US
Practice Address - Phone:615-988-2014
Practice Address - Fax:615-301-6550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-21
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1509210Medicaid
MS04351854Medicaid
MS09015109Medicaid
AR198696002Medicaid
MS09015109Medicaid
MS255543Medicare PIN
AR198696002Medicaid
MSC02499Medicare PIN