Atef Ebrhim, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

45177 Issued in TN

Practice address

133 Dr Robert Lee Rd
Dover, TN 37058-3706

Phone

(931) 232-5141

Fax

(931) 232-3905

NPI assigned

Jul 21, 2008

Last updated

May 28, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TN

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

Family Practice

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clarksville Physician Services, LLCGroup PAC ID 0547276917, 27 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: atef.ebrhim.4@1879.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/1879/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Clarksville Physician Services LLC

  dba Vanderbilt Physician Services Clarksville

  • General Practice Physician
  • Clarksville, TN
  • NPI 1083657829

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Clarksville Physician Services, LLC

  dba Dover Medical Clinic

  • Rural Health Clinic/Center
  • Dover, TN
  • NPI 1992077077
  NPD (past)
• Tennessee Heart and Lung Institute PLC

  • Specialist
  • Clarksville, TN
  • NPI 1699802371
  NPD (past)

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

{
    "created_epoch": "1216598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401235200000",
    "number": "1295990174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 DR ROBERT LEE RD",
            "city": "DOVER",
            "state": "TN",
            "postal_code": "370583706",
            "telephone_number": "931-232-5141",
            "fax_number": "931-232-3905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 DR ROBERT LEE RD",
            "city": "DOVER",
            "state": "TN",
            "postal_code": "370583706",
            "telephone_number": "931-232-5141",
            "fax_number": "931-232-3905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBRHIM",
        "first_name": "ATEF",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-21",
        "last_updated": "2014-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "45177",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4240469",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1515552",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joydianne Damiani-Smith, SLP-CCC
• Erin M Dimond, LMT
• Diversicare Leasing LP (Diversicare of Dover)
• Dover Care Center
• Dana M. Earhart, LPN
• William Aaron Edwards, F.N.P.
• Donna Elkins
• Elizabeth Amelia Estock, NP-C
• Everlasting Hope Counseling Center
• Laura June Ford, DO

• Family Medicine Physician in Dover, TN
• Providers in Dover, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2014; 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.