Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Vanderbilt Coffee Hospital, LLC

Organization Family Medicine Physician · NPI 1417543646

Vanderbilt Coffee Hospital, LLC is a Family Medicine Physician in Tullahoma, Tennessee. Registered with an NPI since 2020.

In the registry since
2020
Specialties on file
8
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

1801 N Jackson St
Tullahoma, TN 37388-8259
Phone: (931) 393-3000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X
Family Medicine Physician Taxonomy 207Q00000X
Obstetrics & Gynecology Physician Taxonomy 207V00000X
Orthopaedic Surgery Physician Taxonomy 207X00000X
Pediatrics Physician Taxonomy 208000000X
Surgery Physician Taxonomy 208600000X
Hospitalist Physician Taxonomy 208M00000X
Nurse Practitioner Taxonomy 363L00000X

Record details

NPI number1417543646
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Angela Simmons — Vp - Finance · (615) 936-8875
NPI enumeratedDecember 11, 2020
Last updated in NPPESAugust 16, 2021
Certification dateAugust 16, 2021
Mailing address719 Thompson Ln Ste 30330, Nashville, TN 37204-4701

Other providers in Tullahoma