Provider Demographics
| NPI: | 1750765434 |
|---|---|
| Name: | SUMNER PHYSICIAN PRACTICES, LLC |
| Entity type: | Organization |
| Organization Name: | SUMNER PHYSICIAN PRACTICES, LLC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | SECRETARY |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | CHARLOTTE |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | LAWRENCE |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 615-920-7000 |
| Mailing Address - Street 1: | 330 SEVEN SPRINGS WAY |
| Mailing Address - Street 2: | ATTEN: PROVIDER ENROLLMENT |
| Mailing Address - City: | BRENTWOOD |
| Mailing Address - State: | TN |
| Mailing Address - Zip Code: | 37027-5098 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 615-920-7000 |
| Mailing Address - Fax: | 615-920-8775 |
| Practice Address - Street 1: | 300 STEAM PLANT RD STE 410 |
| Practice Address - Street 2: | |
| Practice Address - City: | GALLATIN |
| Practice Address - State: | TN |
| Practice Address - Zip Code: | 37066-3065 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 615-328-5089 |
| Practice Address - Fax: | 615-328-6679 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2015-07-13 |
| Last Update Date: | 2024-10-13 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 207LP2900X | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine | Group - Multi-Specialty |
| No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
| No | 207L00000X | Allopathic & Osteopathic Physicians | Anesthesiology | Group - Multi-Specialty | |
| No | 207P00000X | Allopathic & Osteopathic Physicians | Emergency Medicine | Group - Multi-Specialty | |
| No | 207PP0204X | Allopathic & Osteopathic Physicians | Emergency Medicine | Pediatric Emergency Medicine | Group - Multi-Specialty |
| No | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
| No | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | Group - Multi-Specialty |
| No | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Group - Multi-Specialty | |
| No | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | Group - Multi-Specialty | |
| No | 2080P0204X | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Emergency Medicine | Group - Multi-Specialty |
| No | 2084N0400X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | Group - Multi-Specialty |
| No | 208D00000X | Allopathic & Osteopathic Physicians | General Practice | Group - Multi-Specialty | |
| No | 208M00000X | Allopathic & Osteopathic Physicians | Hospitalist | Group - Multi-Specialty | |
| No | 363LC0200X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Critical Care Medicine | Group - Multi-Specialty |
| No | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | Group - Multi-Specialty |