Basic Information
| Provider Information | |||||||||
| NPI: | 1700972015 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCPIKE | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | B | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | II | ||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | |||||||||
| OtherFirstName: | |||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | |||||||||
| Mailing Information | |||||||||
| Address1: | 300 20TH AVE N STE 403 | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372035180 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6152847261 | ||||||||
| FaxNumber: | 6152847501 | ||||||||
| Practice Location | |||||||||
| Address1: | 1840 MEDICAL CENTER PKWY STE 201 | ||||||||
| Address2: | |||||||||
| City: | MURFREESBORO | ||||||||
| State: | TN | ||||||||
| PostalCode: | 371293237 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6158675028 | ||||||||
| FaxNumber: | 6158676650 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/05/2006 | ||||||||
| LastUpdateDate: | 09/01/2021 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | |||||||||
| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | M | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 09/01/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | 63380 | TN | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207RC0001X | 63880 | TN | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Clinical Cardiac Electrophysiology |
ID Information
| ID | Type | State | Issuer | Description | 1700972015 | 01 | IL | TRICARE PRIME ID# | OTHER | 1700972015 | 01 | IL | BCBS OF IL ID# | OTHER | 524102 | 01 | IL | HEALTHLINK ID# | OTHER | 0516995 | 01 | IL | CIGNA ID# | OTHER | 1700972015AA | 01 | IL | ESSENCE ID# | OTHER | 1700972015 | 01 | IL | HUMANA GOLD CHOICE ID# | OTHER | 343215 | 01 | IL | GHP ID# | OTHER | 7041118 | 01 | IL | AETNA ID# | OTHER | 2091091 | 01 | IL | FIRST HEALTH ID# | OTHER | 1700972015 | 01 | IL | TRICARE STANDARD ID# | OTHER | 110074 | 01 | IL | HEALTH ALLIANCE ID# | OTHER | P00612888 | 01 | IL | RR MEDICARE ID# | OTHER |