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NPI Code Detail

MEDICARE: MIDDLE TENNESSEE IMAGING LLC

MEDICARE: MIDDLE TENNESSEE IMAGING 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
1363LF0000XFamily Nurse Practitioner
22085R0202XDiagnostic Radiology PhysicianOCD0000000001TN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00185037OTHERTNRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1770667289
Entity Type Code : Organization
Provider Name (Legal Business Name) : MIDDLE TENNESSEE IMAGING LLC
Provider Business Mailing Address
First Line : PO BOX 306512
Second Line :
City : NASHVILLE
State : TN
Zip : 37230-6545
Country : US
Telephone Number : 615-851-6003
Fax Number : 615-948-8488
Provider Business Practice Location Address
First Line : 812 N CHARLOTTE ST
Second Line :
City : DICKSON
State : TN
Zip : 37055-1009
Country : US
Telephone Number : 615-446-8046
Fax Number :
Authorized Official
Title or Position : AUTHORIZED OFFICIAL
Name : KAREN MARIE VAUGHN
Credential :
Telephone Number : 629-317-1465
Provider Enumeration Date : 10/24/2006
Last Update Date : 05/14/2026

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Directions to “MIDDLE TENNESSEE IMAGING LLC ” Practice Location

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