Avery Mae Pediatrics LLC
Nurse Practitioner, Pediatrics in Thompsons Station, TN. Organization (NPI-2).
NPI number1760140917
StatusActive
Last updated in NPPESDec 6, 2021
Details
- NPI
- 1760140917
- Entity type
- Organization (NPI-2)
- Legal business name
- Avery Mae Pediatrics LLC
- Organization subpart
- No
- Enumeration date
- Dec 6, 2021
- Certification date
- Dec 6, 2021
- Last updated
- Dec 6, 2021
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0200X | Nurse Practitioner, Pediatrics | – | – | Yes |
Practice location
2100 Branford Pl Ste 301Thompsons Station, TN 37179-1010
Phone 615-261-1313
Mailing address
2100 Branford Pl Ste 301Thompsons Station, TN 37179-1010
Phone 615-988-7810
Authorized official
Sarah Catherine Elliott
Owner/Authorized Official
6159887810
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