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NPI Code Detail

MEDICARE: VIP MIDSOUTH, LLC

MEDICARE: VIP MIDSOUTH, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QR1300XRural Health Clinic/Center

General Provider Information

NPI Number : 1528641859
Entity Type Code : Organization
Provider Name (Legal Business Name) : VIP MIDSOUTH, LLC
Provider Business Mailing Address
First Line : 3841 GREEN HILLS VILLAGE DR STE 200
Second Line :
City : NASHVILLE
State : TN
Zip : 37215-2691
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 426 22ND AVE E
Second Line :
City : SPRINGFIELD
State : TN
Zip : 37172-3711
Country : US
Telephone Number : 615-384-0600
Fax Number : 615-452-7862
Authorized Official
Title or Position : PRESIDENT
Name : ROBERT NICK BRANHAM
Credential :
Telephone Number : 615-451-9246
Provider Enumeration Date : 05/04/2021
Last Update Date : 03/23/2026

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Directions to “VIP MIDSOUTH, LLC ” Practice Location

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