Individual provider Active NPI

David Sushilkumar Ebenezer, MD

  • Pediatric Orthopaedic Surgery Physician
  • Nashville, TN
National Provider Identifier
1225222714
Registry record updated Aug 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Orthopaedic Surgery PhysicianTaxonomy code 207XP3100X
License
50084 Issued in TN
Practice address
3601 The Vanderbilt Clinic
Nashville, TN 37232-5100
Phone
(615) 936-3000
NPI assigned
Aug 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 50084 TN
Pediatric Orthopaedic Surgery Physician 207XP3100X 50084 TN Primary

Addresses

Primary practice location

3601 The Vanderbilt Clinic
Nashville, TN 37232-5100

Mailing address

3841 Green Hills Village Dr Ste 200
Nashville, TN 37215-2691
Phone (615) 936-2000

Other practice location 1

3601 The Vanderbilt Clinic
Nashville, TN 37232
Phone (615) 936-3000

Other practice location 2

9300 Valley Childrens Pl
Madera, CA 93636-8761
Phone (559) 353-3000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address debenezer421019@direct.vumc.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130819000753 TN Practitioner - Orthopedic Surgery 1658513759 Reassigns benefits to 1 organization
I20141110002562 CA Practitioner - Orthopedic SurgeryPractitioner - Pediatric Medicine 1658513759 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
132479CAMDClinical Social Worker
50084TNMDPediatric Orthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vanderbilt University Medical Center Orthopaedic Surgery CurrentSince Oct 1, 2018 Accepting new patients
Valley Children'S Medical Group CurrentSince May 15, 2015 Accepting new patients
Valley Children'S Specialty Medical Group, Inc. CurrentSince Sep 29, 2014 Accepting new patients
Vanderbilt University Orthopaedic Surgery PastSince Aug 1, 2013 Accepting new patients
Vanderbilt University Past Accepting new patients

Locations

9300 Valley Childrens Pl
Madera, CA 93636
Phone (559) 353-5700

1524 McHenry Ave
Ste 550570
Modesto, CA 95350
Phone (209) 572-3880

Dept A T 40379
Atlanta, GA 31192

Dept AT 40379
Atlanta, GA 31192

719 Thompson Ln
Nashville, TN 37204
Phone (615) 322-6485

719 Thompson Ln
Ste 30330
Nashville, TN 37204
Phone (615) 936-3871

3841 Green Hills Village Dr
Ste 200
Nashville, TN 37215
Phone (615) 322-6842

Interoperability endpoints

  • Direct secure messaging: debenezer421019@direct.vumc.org

Organizations & group practices 5

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": "1188259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1225222714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3841 GREEN HILLS VILLAGE DR STE 200",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372152691",
            "telephone_number": "615-936-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 THE VANDERBILT CLINIC",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372325100",
            "telephone_number": "615-936-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3601 The Vanderbilt Clinic",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "37232",
            "country_code": "US",
            "telephone_number": "615-936-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9300 Valley Childrens Pl",
            "address_purpose": "LOCATION",
            "city": "Madera",
            "state": "CA",
            "postal_code": "936368761",
            "country_code": "US",
            "telephone_number": "559-353-3000",
            "fax_number": "559-353-5708",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EBENEZER",
        "first_name": "DAVID",
        "middle_name": "SUSHILKUMAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-28",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TN",
            "license": "50084",
            "primary": false
        },
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "TN",
            "license": "50084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "debenezer421019@direct.vumc.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Health Information Service Provider",
            "address_1": "3601 The Vanderbilt Clinic",
            "city": "Nashville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "37232",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

Verify at the official NPI Registry.