30:17 RECOVERY – NPI #1679331284
Internal Medicine

An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine.

Health Care Provider Taxonomy Code for Internal Medicine

30:17 RECOVERY is a provider located in JACKSON, TN. NPPES has assigned the NPI number 1679331284 to 30:17 RECOVERY on March 08, 2024. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207RA0401X from the Health Care Provider Taxonomy code set, which is classified as Internal Medicine, specializing in Addiction Medicine

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for 30:17 RECOVERY below.

NPI Profile for
30:17 RECOVERY

NPI Number
1679331284
Enumeration Date

(more than 2 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
30:17 RECOVERY
Primary location
188 CARRIAGE HOUSE DR
JACKSON, TN 38305-3969
Phone: (731) 215-0049 Fax: (800) 418-1395
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
MELISSA MCBROOM
DIRECTOR
Phone: (731) 215-0449
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207RA0401X
- Internal Medicine / Addiction Medicine (Primary)
101YA0400X
- Counselor / Addiction (Substance Use Disorder)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.