Active NPI
Raoul S Concepcion, MD
- Urology Physician
- Nashville, TN
National Provider Identifier
1104801851
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- MD17400
- Practice address
- 28 White Bridge Rd
Suite 200
Nashville, TN 37205-1499 - Phone
- (615) 290-0622
- NPI assigned
- Dec 14, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | MD17400 | TN | Primary |
| Urology Physician | 208800000X | 37172 | KY |
Addresses
Primary practice location
28 White Bridge Rd
Suite 200
Nashville, TN 37205-1499
Mailing address
28 White Bridge Rd
Suite 200
Nashville, TN 37205-1499
Phone (615) 290-0622
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0108772 | Other | TN | BLUE CROSS |
| 340013316 | Other | TN | RR MEDICARE |
| 64797269 | Medicaid | KY | |
| 3051346 | Medicaid | TN |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37172 | KY | MD | Urology Physician |
| MD17400 | TN | MD | Urology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134518400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492128000000",
"number": "1104801851",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28 WHITE BRIDGE RD",
"address_2": "SUITE 200",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372051499",
"telephone_number": "615-290-0622"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28 WHITE BRIDGE RD",
"address_2": "SUITE 200",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372051499",
"telephone_number": "615-290-0622"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONCEPCION",
"first_name": "RAOUL",
"middle_name": "S",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-12-14",
"last_updated": "2017-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "TN",
"license": "MD17400",
"primary": true
},
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "KY",
"license": "37172",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "0108772",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "340013316",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64797269",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3051346",
"state": "TN"
}
],
"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 Apr 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.