# CAREBRIDGE MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Main Street Medical Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124656616
- **Authorized official:** MELINDA HENDERSON MD (CMO)
- **Authorized official phone:** (615) 585-1181

## Contact information

- **Practice address:** 501 GREAT CIRCLE RD FL 3, NASHVILLE, TN 37228-1317
- **Practice address phone:** (615) 436-9060
- **Practice address fax:** (615) 235-9725
- **Mailing address:** 501 GREAT CIRCLE RD FL 3, NASHVILLE, TN 37228-1317
- **Mailing address phone:** (615) 436-9060
- **Mailing address fax:** (615) 235-9725

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207RG0300X | Geriatric Medicine (Internal Medicine) Physician | — | NULL | — |
| 207RG0300X | Geriatric Medicine (Internal Medicine) Physician | — | — | — |
| 207RH0002X | Hospice and Palliative Medicine (Internal Medicine) Physician | — | NULL | — |
| 207RH0002X | Hospice and Palliative Medicine (Internal Medicine) Physician | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |
| 363LA2200X | Adult Health Nurse Practitioner | — | NULL | — |
| 363LA2200X | Adult Health Nurse Practitioner | — | — | — |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 03/30/2020
- **Last updated:** 05/14/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0131687 | — | IA |
| 05 | — | 108794900 | — | FL |
| 05 | — | 1124656616 | — | MN |
| 05 | — | 1124656616 | — | VA |
| 05 | — | 157006 | — | AZ |
| 05 | — | 201337990A | — | KS |
| 05 | — | 422490901 | — | TN |
| 05 | — | Q056232 | — | TN |