Vandana Botta
Individual provider Active NPI Internal Medicine Physician · McMinnville, TN
NPI 1013335728 · NPPES record last updated Mar 22, 2023
Key facts
- NPI
- 1013335728
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 61540 (TN)
- Practice address
- 1559 Sparta St
McMinnville, TN 37110-1316 - Phone
- (931) 815-4000
- NPI assigned
- Mar 31, 2014
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Southeastern Physician Services PC
Practice addresses (Care Compare)
1995 Hwy 51 S
Covington, TN 38019-3635
Phone (901) 475-5523
Hospital & facility affiliations
- Baptist Memorial Hospital Tipton
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221230001102 | TN | Practitioner - Internal Medicine | 4486058781 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pepper Branch Physician Services, PC | Internal Medicine | Current |
Accepting new patients |
| Southeastern Physician Services PC | Internal Medicine | Current |
Accepting new patients |
| Saint Thomas Medical Partners | Internal Medicine | Current |
Accepting new patients |
Locations
1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325
1559 Sparta St
McMinnville, TN 37110
Phone (615) 406-9544
300 20th Ave N
Fl 9
Nashville, TN 37203
401 Sewell Dr
Sparta, TN 38583
Phone (931) 738-2164
1201 Bishop St
Union City, TN 38261
Phone (423) 698-6061
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 61540 | TN | Yes |
Addresses
Primary practice location
1559 Sparta St
McMinnville, TN 37110-1316
Mailing address
University of Tennessee
910 Madison Avenue Suite 1031
Memphis, TN 38163-0001
Phone (901) 448-7635
Other practice location 1
University Of Tennessee
910 Madison Avenue Suite 1031
Memphis, TN 38163-0001
Phone (901) 448-7635
Other providers in McMinnville, TN
- Blessed Beyond Home Care
- Blooming Minds Counseling LLC
- Bluff Springs Manor LLC
- Abbey Bond
- Angela Bond
- Steven Leander Bouldin
- Heidi M Bradley
- Alexander M Brown
- Cynthia Brown
- Kristina L Brown
All providers in McMinnville, TN · Internal Medicine Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 22, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.