Provider Demographics
NPI:1336309806
Name:GERIATRIX CONSULTING LLC
Entity Type:Organization
Organization Name:GERIATRIX CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTY
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:ROACH
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:615-686-7773
Mailing Address - Street 1:PO BOX 1184
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37088-1184
Mailing Address - Country:US
Mailing Address - Phone:615-686-7773
Mailing Address - Fax:
Practice Address - Street 1:1483 N MOUNT JULIET RD
Practice Address - Street 2:#220
Practice Address - City:MOUNT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-3315
Practice Address - Country:US
Practice Address - Phone:615-773-7775
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-09
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN310400000X, 313M00000X, 314000000X, 315D00000X
TNAPN10671363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living FacilityGroup - Single Specialty
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN33466772Medicare PIN