Sudhir K Bagga, MD
Individual provider Active NPI Family Medicine Physician · Shelbyville, TN
NPI 1073595385 · NPPES record last updated Nov 1, 2010
Key facts
- NPI
- 1073595385
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- MD38741 (TN)
- Practice address
- 2839 Highway 231 N
Suite 105
Shelbyville, TN 37160-7447 - Phone
- (931) 685-8020
- Fax
- (931) 685-8046
- NPI assigned
- Nov 14, 2005
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD38741 | TN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rupard & Speake Medical Group PLLC | Family Medicine | Past | Accepting new patients |
| Shelbyville Clinic Corp | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD38741 | TN | Yes |
Addresses
Primary practice location
2839 Highway 231 N
Suite 105
Shelbyville, TN 37160-7447
Mailing address
2839 Highway 231 N
Suite 105
Shelbyville, TN 37160-7447
Phone (931) 685-8020
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4109044 | Other | TN | BCBS |
Other providers in Shelbyville, TN
- Amber Archer
- Nabil Atalla
- Angela Atonsa
- Emily Sarah Averitt
- B2Z Care Services LLC
- Barbara F Kaczmarska
- David E Barnes
- Monica Noel Barnes
- Amber Barrett
- Kristi M Barrett
All providers in Shelbyville, TN · Family 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 Nov 1, 2010. 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).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.