Provider Demographics
NPI:1194417022
Name:BEATING PULSE LLC
Entity type:Organization
Organization Name:BEATING PULSE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:A
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:FNP-BC
Authorized Official - Phone:615-797-8573
Mailing Address - Street 1:5350 CAVENDISH DR
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37128-2732
Mailing Address - Country:US
Mailing Address - Phone:615-542-6439
Mailing Address - Fax:
Practice Address - Street 1:529 BRANDIES CIR
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37128-0710
Practice Address - Country:US
Practice Address - Phone:615-542-6439
Practice Address - Fax:747-215-5340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-22
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ076555Medicaid