Virtual Consult MD LLC
Organization Active NPI Psychiatry Physician · Hendereson, KY
NPI 1174136337 · NPPES record last updated Dec 20, 2023
Key facts
- NPI
- 1174136337
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatry Physician 2084P0800X
- Legal business name
- VIRTUAL CONSULT MD LLC
- Practice address
- 2202 Hwy 41 North
Unit E 152
Hendereson, KY 42420 - Phone
- (812) 848-2322
- Fax
- (812) 727-5469
- NPI assigned
- Aug 27, 2020
- Organization subpart
- No
Authorized official
- Name
- Dr. Neil Jariwala, MD
- Title
- Owner
- Phone
- (678) 200-0048
Practitioners 2
-
Neil Jariwala, M.D.
-
Sharon Jeanette Williams, APRN
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200915001373 | KY | Part B Supplier - Clinic/Group Practice | 8527486067 |
Receives reassigned benefits from 2 practitioners Practice locations: Owensboro, KY |
National Provider Directory
Locations
2202 US Highway 41 N
Unit E152
Henderson, KY 42420
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician |
2084P0800X | Yes | ||
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X |
Addresses
Primary practice location
2202 Hwy 41 North
Unit E 152
Hendereson, KY 42420
Mailing address
1222 Professional Blvd
Evansville, IN 47714-8002
Phone (812) 720-3800
Other practice location 1
1102 Triplett St Ste 2300
Owensboro, KY 42303-3120
Phone (812) 720-3800
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 53374 | Other | KY | MEDICAL LICENSE |
Other names
- Virtual Consult MD, LLC
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | EVANSVILLE | Other |
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 20, 2023. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.