Supriya Kohli, M.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

52489 Issued in TN

Practice address

1 Medical Center Blvd
Suite 103
Cookeville, TN 38501-4294

Phone

(931) 783-2770

Fax

(931) 525-1176

NPI assigned

Jun 3, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Neurology

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Proactive Therapy, IncGroup PAC ID 0143245415, 118 clinicians

Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Health Lexington Hospital, Lexington, KY, CCN 180103
• Baptist Health Richmond Hospital, Richmond, KY, CCN 180049

Merit-based Incentive Payment System (MIPS)

Final score

94.29 of 100Reported as apm

Quality

87.32

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Baptist Health Medical Group Inc

  • Nurse Practitioner
  • Lexington, KY
  • NPI 1518360296
  Medicare reassignment Care Compare group NPD
• Proactive Therapy, Inc

  • Occupational Therapist
  • Frankfort, KY
  • NPI 1932132149
  Care Compare group
• Baptist Health Medical Group Inc

  • Rural Health Clinic/Center
  • Dawson Springs, KY
  • NPI 1982178216
  NPD
• Cookeville Regional Medical Center

  • Hospitalist Physician
  • Cookeville, TN
  • NPI 1023397031
  NPD (past)
• Baptist Health Medical Group Inc

  • Internal Medicine Physician
  • Louisville, KY
  • NPI 1780961300

  Neurology

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baptist Healthcare System, Inc

  • General Acute Care Hospital
  • Lexington, KY
  • NPI 1538244918
  Care Compare affiliation
• Baptist Healthcare System, Inc.

  • General Acute Care Hospital
  • Richmond, KY
  • NPI 1568452290
  Care Compare affiliation

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

{
    "created_epoch": "1307059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1194019570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 LEXINGTON GREEN CIR",
            "address_2": "STE 600",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405033326",
            "telephone_number": "859-971-4695",
            "fax_number": "859-971-4604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER BLVD",
            "address_2": "SUITE 103",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385014294",
            "telephone_number": "931-783-2770",
            "fax_number": "931-525-1176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "406 N Whitney Ave Ste 3",
            "address_purpose": "LOCATION",
            "city": "Cookeville",
            "state": "TN",
            "postal_code": "385014243",
            "country_code": "US",
            "telephone_number": "931-783-4901",
            "fax_number": "931-783-4901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOHLI",
        "first_name": "SUPRIYA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-03",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TN",
            "license": "52489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100421860",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q020404",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "6060965",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "skohli72904@bhkydirect.com",
            "affiliation": "N",
            "address_1": "2101 Nicholasville Rd Ste 204",
            "city": "Lexington",
            "state": "KY",
            "country_code": "US",
            "postal_code": "405032525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christopher J Klugewicz, M.D.
• Martha Ashley Knowles, M.A.
• Gowthami Kobbari, MD
• Abigail Lyn Koch, RBT
• Corey T Kocisko, CRNA
• Rebecca Rae Kojak, DNP, RN
• Hima B Kona, MD
• Anne Kosgei
• Trina Nadia Kreil, D.C.
• Mark D Kriskovich, M.D.

• Neurology Physician in Cookeville, TN
• Providers in Cookeville, TN by specialty
• Neurology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.