Provider Demographics
NPI:1255339396
Name:NOPCO OF TENNESSEE, INC.
Entity type:Organization
Organization Name:NOPCO OF TENNESSEE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:A
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:615-327-2882
Mailing Address - Street 1:1707 STATE ST
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2929
Mailing Address - Country:US
Mailing Address - Phone:615-327-2882
Mailing Address - Fax:615-327-2883
Practice Address - Street 1:1707 STATE ST
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2929
Practice Address - Country:US
Practice Address - Phone:615-327-2882
Practice Address - Fax:615-327-2883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN224P00000X, 222Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotistGroup - Multi-Specialty
No224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1454190Medicaid
TN4228520001Medicare ID - Type Unspecified