Healthcare Provider Details

I. General information

NPI: 1932112620
Provider Name (Legal Business Name): CORNERSTONE PULMONARY AND CRITICAL CARE ASSOCIATES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1424 BADDOUR PARKWAY H
LEBANON TN
37087
US

IV. Provider business mailing address

PO BOX 748
LEBANON TN
37088-0748
US

V. Phone/Fax

Practice location:
  • Phone: 615-444-8686
  • Fax: 615-444-7793
Mailing address:
  • Phone: 615-444-8686
  • Fax: 615-444-7793

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number40614
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number40614
License Number StateTN

VIII. Authorized Official

Name: DR. MODUPE KEHINDE
Title or Position: SOLE MEMBER
Credential: M.D.
Phone: 615-444-8686