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VANDERBILT INTEGRATED INTERNAL MEDICINE
NPI 1164200747
Clinic/Center - Rural Health in Tullahoma, TN

Active since September 15, 2023CLIA 44D0309810 · Waiver
1805 N JACKSON ST STE 100, TULLAHOMA, TN 37388(931) 455-7767(931) 222-4057 Get Directions Write a Review

NPPES record last updated: June 12, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Vanderbilt Integrated Internal Medicine NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

VANDERBILT INTEGRATED INTERNAL MEDICINE (NPI 1164200747) is a healthcare organization registered as a rural health in Tullahoma, Tennessee and active in the NPI registry since September 2023. The organization holds a CLIA Waiver certificate valid through February 28, 2027 and lists Wendy D Monaci, Vice President, as its authorized official.

NPPES Registry Identity

NPI1164200747
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameVANDERBILT INTEGRATED PROVIDERS, LLC
Location Address1805 N JACKSON ST STE 100Tullahoma, TN 37388-2291
Mailing Address3841 Green Hills Village Dr Ste 200Nashville, TN 37215-2691
Phone(931) 455-7767
Fax(931) 222-4057
Organization SubpartNo
Authorized OfficialWendy D MonaciVice President · (615) 936-3944
Enumeration DateSeptember 15, 2023
Last NPPES UpdateJune 12, 2024
NPPES CertifiedJune 12, 2024
✔ NPI 1164200747 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
1805 N JACKSON ST STE 100, Tullahoma, TN 37388
Open in Google Maps ↗

Other Names 1

Doing Business AsVanderbilt Integrated Internal Medicine

Other Identifiers 1

MedicaidQ092315TN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Magnolia Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 44D0309810

Vanderbilt Integrated Providers, LLC Vanderbilt Integrated Internal Medicine · Tullahoma, TN
Active · expires Feb 28, 2027
CLIA Number44D0309810
Laboratory TypeRural Health Clinic
Certificate Effective DateMarch 1, 2025
Certificate Expiration DateFebruary 28, 2027
Laboratory DirectorDr. Robert H. Nichols Jr
Laboratory Phone(931) 393-3000
Laboratory LocationVanderbilt Integrated Providers, LLC Vanderbilt Integrated Internal Medicine1805 N Jackson St, Suite 100, Tullahoma, TN 37388
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHELBYVILLE HOSPITAL COMPANY LLC
Clinic/Center (Rural Health)
1805 N JACKSON ST STE 100
TULLAHOMA, TN 37388
Coffee County (931) 455-7767
JUSTIN NEAL MILLER MD
Internal Medicine
1805 N JACKSON ST STE 100
TULLAHOMA, TN 37388
Coffee County (931) 455-7767
MRS. KATHRYN ELIZABETH WALLER FNP-C
Nurse Practitioner (Family)
1805 N JACKSON ST STE 100
TULLAHOMA, TN 37388
Coffee County (931) 455-7767
DR. COLLIN CRUTCHER BILLS M.D.
Orthopaedic Surgery
1805 N JACKSON ST STE 100
TULLAHOMA, TN 37388
Coffee County (901) 448-5364

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Vanderbilt Integrated Providers, LLC's NPI number?

The NPI number for Vanderbilt Integrated Providers, LLC is 1164200747. It was assigned to this organization in the NPPES registry on September 15, 2023. The provider is doing business as Vanderbilt Integrated Internal Medicine.

Where is Vanderbilt Integrated Providers, LLC located?

Vanderbilt Integrated Providers, LLC is located at 1805 N Jackson St Ste 100, Tullahoma, TN 37388. The listed phone number is (931) 455-7767.

What is Vanderbilt Integrated Providers, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Does Vanderbilt Integrated Providers, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 44D0309810) is associated with this NPI, valid through February 28, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Vanderbilt Integrated Providers, LLC accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Magnolia Health, Ambetter of Alabama and Ambetter of North Carolina and 1 other insurer list Vanderbilt Integrated Providers, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Vanderbilt Integrated Providers, LLC was last updated on June 12, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.