Active NPI
Philip James Ludwig, M.D.
- Surgery Physician
- McMinnville, TN
National Provider Identifier
1154408920
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 01753
- Practice address
- 1589 Sparta St
Ste 106
McMinnville, TN 37110 - Phone
- (931) 815-4580
- Fax
- (931) 815-4583
- NPI assigned
- Nov 1, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 01753 | NC | Primary |
Addresses
Primary practice location
1589 Sparta St
Ste 106
McMinnville, TN 37110
Mailing address
1589 Sparta St
Ste 106
McMinnville, TN 37110
Phone (931) 815-4580
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01753 | Other | NC | NC STATE LICENSE |
| 33660 | Other | NC | BCBS NC |
| 8933660 | Medicaid | NC |
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 |
|---|---|---|---|
| 01753 | NC | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| River Park Hospitalists, LLC | Past | Accepting new patients | |
| River Park Physician Group LLC | Past | Accepting new patients | |
| Carilion Healthcare Corporation | Past | Accepting new patients |
Interoperability endpoints
- https://api.platform.athenahealth.com/1925/brand/4/csg/41/fhir/r4
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.
-
dba River Park Anesthesia
- Certified Registered Nurse Anesthetist
- McMinnville, TN
- NPI 1437326964
-
- Orthopaedic Surgery Physician
- MC Minnville, TN
- NPI 1558508028
-
dba Bridgewater College Student Health Center
- Multi-Specialty Clinic/Center
- Roanoke, VA
- NPI 1447206370
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210204800000",
"number": "1154408920",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1589 SPARTA ST",
"address_2": "STE 106",
"city": "MCMINNVILLE",
"state": "TN",
"postal_code": "37110",
"telephone_number": "931-815-4580",
"fax_number": "931-815-4583"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1589 SPARTA ST",
"address_2": "STE 106",
"city": "MCMINNVILLE",
"state": "TN",
"postal_code": "37110",
"telephone_number": "931-815-4580",
"fax_number": "931-815-4583"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUDWIG",
"first_name": "PHILIP",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-01",
"last_updated": "2008-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NC",
"license": "01753",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NC STATE LICENSE",
"identifier": "01753",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS NC",
"identifier": "33660",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8933660",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in McMinnville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.