Individual provider Active NPI

Robert Jeffrey Mahoney, MD

  • Diagnostic Radiology Physician
  • Nashville, TN
National Provider Identifier
1043206329
Registry record updated Apr 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD35641 Issued in TN
Practice address
3601 The Vanderbilt Clinic
Nashville, TN 37232-0001
Phone
(615) 936-2000
NPI assigned
Sep 22, 2005
Last updated
Apr 9, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD35641 TN Primary

Addresses

Primary practice location

3601 The Vanderbilt Clinic
Nashville, TN 37232-0001

Mailing address

719 Thompson LN Ste 30330
Nashville, TN 37204-4701

Other practice location 1

1224 Trotwood Ave
Southern Radiology Associates, PLL
Columbia, TN 38401-4802
Phone (931) 647-5034

Other practice location 2

1224 Trotwood Ave
Southern Radiology Associates, PLL
Columbia, TN 38401-4802
Phone (931) 647-5034

Other practice location 3

1700 Medical Center Pkwy
Murfreesboro, TN 37129
Phone (615) 396-4100

Other practice location 4

337 22nd Ave N
Nashville, TN 37203-1840
Phone (615) 327-1500

Other practice location 5

2009 Mallory Ln Ste 150
Franklin, TN 37067-2872
Phone (615) 771-8668

Other practice location 6

4525 Harding Pike Ste 102
Nashville, TN 37205-2145
Phone (615) 463-3034

Other practice location 7

719 Thompson Ln Ste 23300
Nashville, TN 37204-4686
Phone (615) 936-3606

Other practice location 8

1909 Acklen Ave
Nashville, TN 37212-3713
Phone (615) 777-9729

Other identifiers 2

IdentifierTypeStateIssuer
4086061OtherTNBLUE CROSS PROVIDER NUMBE
3880059MedicaidTN

Electronic endpoints 5

TypeEndpointUseAffiliation
Direct Messaging Address rmahoney595102@direct.vumc.org Direct
Direct Messaging Address rmahoney595102@direct.vumc.org Direct Williamson Imaging, LLC
Direct Messaging Address rmahoney595102@direct.vumc.org Direct One Hundred Oaks Imaging, LLC
Direct Messaging Address rmahoney595102@direct.vumc.org Direct Vanderbilt Imaging Services, LLC
Direct Messaging Address rmahoney595102@direct.vumc.org Direct Vanderbilt Imaging Services, LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040713000403 TN Practitioner - Diagnostic Radiology 6800874017 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Tennessee, HSC, College of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dickson Medical Associates, PCGroup PAC ID 3971408774, 55 clinicians

Practice addresses (Care Compare)

127 Crestview Park Dr
Dickson, TN 37055-2855
Phone (615) 446-5121

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD35641TNMDDiagnostic Radiology Physician
35641TNMDNeonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
One Hundred Oaks Imaging, LLC Diagnostic Radiology CurrentSince Sep 10, 2020 Accepting new patients
Dickson Medical Associates PC CurrentSince Aug 12, 2024 Accepting new patients
Dickson Medical Associates, PC CurrentSince Aug 12, 2024 Accepting new patients
Vanderbilt University PastSince Sep 10, 2020 Accepting new patients

Locations

127 Crestview Park Dr
Dickson, TN 37055
Phone (615) 441-4478

127 Crestview Park Dr
Ste 209
Dickson, TN 37055

4525 Harding Pike
Ste 102
Nashville, TN 37205
Phone (615) 463-3034

719 Thompson Ln
Ste 23300
Nashville, TN 37204
Phone (615) 936-3606

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617926400000",
    "number": "1043206329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 THOMPSON LN STE 30330",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372044701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 THE VANDERBILT CLINIC",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372320001",
            "telephone_number": "615-936-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1224 Trotwood Ave",
            "address_2": "Southern Radiology Associates, PLL",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "TN",
            "postal_code": "384014802",
            "country_code": "US",
            "telephone_number": "931-647-5034",
            "fax_number": "931-552-6663",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1224 Trotwood Ave",
            "address_2": "Southern Radiology Associates, PLL",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "TN",
            "postal_code": "384014802",
            "country_code": "US",
            "telephone_number": "931-647-5034",
            "fax_number": "931-552-6663",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1700 Medical Center Pkwy",
            "address_purpose": "LOCATION",
            "city": "Murfreesboro",
            "state": "TN",
            "postal_code": "37129",
            "country_code": "US",
            "telephone_number": "615-396-4100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "337 22nd Ave N",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372031840",
            "country_code": "US",
            "telephone_number": "615-327-1500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2009 Mallory Ln Ste 150",
            "address_purpose": "LOCATION",
            "city": "Franklin",
            "state": "TN",
            "postal_code": "370672872",
            "country_code": "US",
            "telephone_number": "615-771-8668",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4525 Harding Pike Ste 102",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372052145",
            "country_code": "US",
            "telephone_number": "615-463-3034",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "719 Thompson Ln Ste 23300",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372044686",
            "country_code": "US",
            "telephone_number": "615-936-3606",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1909 Acklen Ave",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372123713",
            "country_code": "US",
            "telephone_number": "615-777-9729",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAHONEY",
        "first_name": "ROBERT",
        "middle_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-22",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TN",
            "license": "MD35641",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER NUMBE",
            "identifier": "4086061",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3880059",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rmahoney595102@direct.vumc.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Health Information Service Provider",
            "address_1": "3601 The Vanderbilt Clinic",
            "city": "Nashville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "372320001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rmahoney595102@direct.vumc.org",
            "affiliation": "Y",
            "affiliationName": "Williamson Imaging, LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Health Information Service Provider",
            "address_1": "2009 Mallory Ln Ste 150",
            "city": "Franklin",
            "state": "TN",
            "country_code": "US",
            "postal_code": "370672872",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rmahoney595102@direct.vumc.org",
            "affiliation": "Y",
            "affiliationName": "One Hundred Oaks Imaging, LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Health Information Service Provider",
            "address_1": "719 Thompson Ln Ste 23300",
            "city": "Nashville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "372044686",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rmahoney595102@direct.vumc.org",
            "affiliation": "Y",
            "affiliationName": "Vanderbilt Imaging Services, LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Health Information Service Provider",
            "address_1": "4525 Harding Pike Ste 102",
            "city": "Nashville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "372052145",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rmahoney595102@direct.vumc.org",
            "affiliation": "Y",
            "affiliationName": "Vanderbilt Imaging Services, LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Health Information Service Provider",
            "address_1": "1909 Acklen Ave",
            "city": "Nashville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "372123713",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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Sources for this page

Verify at the official NPI Registry.