Basic Information
Provider Information | |||||||||
NPI: | 1790766319 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | MCHUGH | ||||||||
FirstName: | DANIEL | ||||||||
MiddleName: | J | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | MD | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 131 SAUNDERSVILLE RD | ||||||||
Address2: | SUITE 160 | ||||||||
City: | HENDERSONVILLE | ||||||||
State: | TN | ||||||||
PostalCode: | 370758903 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 6153486231 | ||||||||
FaxNumber: | 8882950304 | ||||||||
Practice Location | |||||||||
Address1: | 2400 PATTERSON ST | ||||||||
Address2: | SUITE 217 | ||||||||
City: | NASHVILLE | ||||||||
State: | TN | ||||||||
PostalCode: | 372031562 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 6153214617 | ||||||||
FaxNumber: | 6153214621 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 11/10/2005 | ||||||||
LastUpdateDate: | 10/03/2018 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | 26759 | TN | N |   | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |   | 2081P2900X | MD26759 | TN | N |   | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Pain Medicine | 208VP0014X | 26759 | TN | Y |   | Allopathic & Osteopathic Physicians | Pain Medicine | Interventional Pain Medicine |
ID Information
ID | Type | State | Issuer | Description | 3090846 | 05 | TN |   | MEDICAID | 3045779 | 01 | TN | BCBS | OTHER |