MEDICARE: ST. DAVID'S ORTHO, NEURO AND REHAB, PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	2084N0400X	Neurology Physician
2	207RX0202X	Medical Oncology Physician
3	208100000X	Physical Medicine & Rehabilitation Physician
4	207X00000X	Orthopaedic Surgery Physician

General Provider Information

NPI Number	:	1669742755
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ST. DAVID'S ORTHO, NEURO AND REHAB, PLLC

Provider Business Mailing Address
First Line	:	2000 HEALTH PARK DR
Second Line	:
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-4692
Country	:	US
Telephone Number	:	615-373-7406
Fax Number	:

Provider Business Practice Location Address
First Line	:	98 SAN JACINTO BLVD
Second Line	:	SUITE 1800
City	:	AUSTIN
State	:	TX
Zip	:	78701-4082
Country	:	US
Telephone Number	:	512-708-9700
Fax Number	:	512-410-2942

Authorized Official
Title or Position	:	GROUP VICE PRESIDENT
Name	:	NICHOLAS WADLINGTON
Credential	:
Telephone Number	:	615-372-7332

Provider Enumeration Date	:	01/05/2012
Last Update Date	:	11/20/2025

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