Healthcare Provider Details

I. General information

NPI: 1871836148
Provider Name (Legal Business Name): CARESPOT OF HERMITAGE (5225 OLD HICKORY BOULEVARD), LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2013
Last Update Date: 01/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5225 OLD HICKORY BLVD SUITE 205
HERMITAGE TN
37076-2594
US

IV. Provider business mailing address

PO BOX 742529
ATLANTA GA
30374-2529
US

V. Phone/Fax

Practice location:
  • Phone: 615-938-7190
  • Fax: 615-938-7191
Mailing address:
  • Phone: 972-745-7500
  • Fax: 972-745-4336

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. RHONDA MCKINNEY
Title or Position: AVP REVENUE CYCLE URGENT CARE
Credential:
Phone: 972-906-8162