Healthcare Provider Details

I. General information

NPI: 1427442680
Provider Name (Legal Business Name): JEFFREY DINIZIO PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2015
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

919 MURFREESBORO RD
FRANKLIN TN
37064-3002
US

IV. Provider business mailing address

3841 GREEN HILLS VILLAGE DR STE 200
NASHVILLE TN
37215-2691
US

V. Phone/Fax

Practice location:
  • Phone: 615-791-7373
  • Fax:
Mailing address:
  • Phone:
  • Fax: 615-322-5048

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number3599
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number3599
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number018514
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: