VANDERBILT COFFEE HOSPITAL, LLC
NPI 1417543646
Internal Medicine in Tullahoma, TN

Q: What is Vanderbilt Coffee Hospital, LLC's NPI number?

The NPI number for Vanderbilt Coffee Hospital, LLC is 1417543646. It was assigned to this organization in the NPPES registry on December 11, 2020.

Q: What is Vanderbilt Coffee Hospital, LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Active since December 11, 2020CLIA 44D0309812 · Accreditation

1801 N JACKSON ST, TULLAHOMA, TN 37388(931) 393-3000 Get Directions Write a Review

NPPES record last updated: August 16, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 16, 2021, Dec 16, 2020, Dec 11, 2020 (3 updates tracked since 2020).

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About Vanderbilt Coffee Hospital, Llc NPPES

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

VANDERBILT COFFEE HOSPITAL, LLC (NPI 1417543646) is a healthcare organization registered as an internal medicine in Tullahoma, Tennessee and active in the NPI registry since December 2020. The organization holds an CLIA Accreditation certificate valid through January 2, 2027 and lists Angela L Simmons, Vp - Finance, as its authorized official.

NPPES Registry Identity

NPI1417543646

Entity TypeOrganization

Primary Taxonomy207R00000X

Legal Business NameVANDERBILT COFFEE HOSPITAL, LLC

Location Address1801 N JACKSON STTullahoma, TN 37388-8259

Mailing Address719 Thompson Ln Ste 30330Nashville, TN 37204-4701

Phone(931) 393-3000

Organization SubpartNo

Authorized OfficialAngela L SimmonsVp - Finance · (615) 936-8875

Enumeration DateDecember 11, 2020

Last NPPES UpdateAugust 16, 20213 updates tracked since enumeration

NPPES CertifiedAugust 16, 2021

✔ NPI 1417543646 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 8

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Also ListedFamily MedicineTaxonomy 207Q00000X

Also ListedObstetrics & GynecologyTaxonomy 207V00000X

Also ListedOrthopaedic SurgeryTaxonomy 207X00000X

Also ListedPediatricsTaxonomy 208000000X

Also ListedSurgeryTaxonomy 208600000X

Also ListedHospitalistTaxonomy 208M00000X

Also ListedNurse PractitionerTaxonomy 363L00000X

1801 N JACKSON ST, Tullahoma, TN 37388

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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 Accreditation 44D0309812

Vanderbilt Coffee Hospital Dba Vanderbilt Tullahoma-Harton Hospital · Tullahoma, TN

Active · expires Jan 2, 2027

CLIA Number44D0309812

Laboratory TypeHospital

Certificate Effective DateJanuary 3, 2025

Certificate Expiration DateJanuary 2, 2027

Laboratory DirectorBrent Sterling

Laboratory Phone(931) 393-3000

Laboratory LocationVanderbilt Coffee Hospital Dba Vanderbilt Tullahoma-Harton Hospital1801 N Jackson St, Tullahoma, TN 37388

CLIA data matches this NPI record on: Address Name Phone

This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Other Providers at the Same Location NPPES 20

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

MS. PENNY CAROLYN TIPPS PT

Physical Therapist