Individual provider Active NPI

Grayson H Wheatley III, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Nashville, TN
National Provider Identifier
1083615934
Registry record updated Oct 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
54798 Issued in TN
Practice address
2400 Patterson St
Suite 307
Nashville, TN 37203-1562
Phone
(615) 342-6900
Fax
(615) 342-6899
NPI assigned
Aug 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 33217 AZ
Surgery Physician 208600000X MD448565 PA
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 54798 TN Primary

Addresses

Primary practice location

2400 Patterson St
Suite 307
Nashville, TN 37203-1562

Mailing address

2400 Patterson St
Suite 307
Nashville, TN 37203-1562
Phone (615) 342-6900

Other identifiers 4

IdentifierTypeStateIssuer
P00219385OtherAZRAILROAD MEDICARE
54798OtherTNTN MEDICAL LICENSE
891186MedicaidAZ
WCSKQOtherAZSUN HEALTH GROUP #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD448565PAMDSurgery Physician
54798TNMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centennial Heart LLC Past Accepting new patients
VHS Arizona Heart Institute Inc Past Accepting new patients
Ahi Cardiovascular Surgeons LTD Surgery Past Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475452800000",
    "number": "1083615934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 PATTERSON ST",
            "address_2": "SUITE 307",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031562",
            "telephone_number": "615-342-6900",
            "fax_number": "615-342-6899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 PATTERSON ST",
            "address_2": "SUITE 307",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031562",
            "telephone_number": "615-342-6900",
            "fax_number": "615-342-6899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEATLEY",
        "first_name": "GRAYSON",
        "middle_name": "H",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2016-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "AZ",
            "license": "33217",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD448565",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "TN",
            "license": "54798",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00219385",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TN MEDICAL LICENSE",
            "identifier": "54798",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891186",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUN HEALTH GROUP #",
            "identifier": "WCSKQ",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.