Healthcare Provider Details

I. General information

NPI: 1801000765
Provider Name (Legal Business Name): HEALTHSPRING OF TENNESSEE, INC. PDP S5932
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44 VANTAGE WAY SUITE 300
NASHVILLE TN
37228-1550
US

IV. Provider business mailing address

44 VANTAGE WAY SUITE 300
NASHVILLE TN
37228-1550
US

V. Phone/Fax

Practice location:
  • Phone: 615-291-7039
  • Fax: 832-553-3584
Mailing address:
  • Phone: 615-291-7039
  • Fax: 832-553-3584

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number11522
License Number StateTN

VIII. Authorized Official

Name: MRS. TERESA RJ JORDAN
Title or Position: GENERAL COUNSEL
Credential:
Phone: 832-553-3375