Organization
ST. THOMAS MEDICAL GROUP PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM P. GRAYSON (EXECUTIVE DIRECTOR)
(615) 250-4142
Entity
Organization
Contact information
Practice address
4230 HARDING PIKE, SUITE 400, NASHVILLE, TN 37205-2013
(615) 297-2700
(615) 386-2399
Mailing address
104 WOODMONT BLVD, SUITE LL50, NASHVILLE, TN 37205-2382
(615) 386-2300
(615) 386-2399
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RG0100X
Gastroenterology Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
—
207Y00000X
Otolaryngology Physician
—
—
231H00000X
Audiologist
—
—
363L00000X
Nurse Practitioner
—
—
363LA2100X
Acute Care Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10074025
AMERIGROUP
TN
01
—
166556000
OWCP DOL WORK COMP - MEDICAL PROVIDERS
TN
05
—
3721520
—
TN
01
—
4019754
BLUE CROSS OF TN
TN
01
—
613258400
OWCP - DOL AUDIOLOGISTS
TN
05
—
65940066
—
KY
01
—
CB3852
MEDICARE RR
TN
Enumeration date
07/21/2006
Last updated
02/17/2014
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