Provider Demographics
NPI:1194921296
Name:CUMBERLAND BRAIN & SPINE, PLLC
Entity type:Organization
Organization Name:CUMBERLAND BRAIN & SPINE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-NEUROSURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:TALEGHANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-884-0001
Mailing Address - Street 1:5653 FRIST BLVD
Mailing Address - Street 2:STE 731
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-2066
Mailing Address - Country:US
Mailing Address - Phone:866-781-1772
Mailing Address - Fax:615-884-0009
Practice Address - Street 1:5653 FRIST BLVD
Practice Address - Street 2:STE 731
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-2066
Practice Address - Country:US
Practice Address - Phone:866-781-1772
Practice Address - Fax:615-884-0009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-25
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000036852207T00000X
KY37636208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64060767Medicaid
KYH81669Medicare UPIN
KY1941401Medicare ID - Type UnspecifiedMEDICARE PROVIDER #
TN6400670002Medicare NSC
KY64060767Medicaid