Muljibhai J Thakkar, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

0101031664 Issued in VA

Practice address

6719 Governor G.C. Peery Hwy
Suite 2600
Richlands, VA 24641-0279

Phone

(276) 964-6649

Fax

(276) 964-5007

NPI assigned

Mar 17, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: muljibhai.thakkar@vab.hcadirect.net

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.

• Tri State Clinic, Inc.

  dba Tri State Rural Health Clinic

  • Rural Health Clinic/Center
  • Grundy, VA
  • NPI 1124097795
  NPD (past)
• Tri State Clinic, Inc.

  dba Tri State Rural Health Clinic

  • Internal Medicine Physician
  • Grundy, VA
  • NPI 1518083971
  NPD (past)

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530576000000",
    "number": "1316916505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6719 GOVERNOR G.C. PEERY HWY",
            "address_2": "SUITE 2600",
            "city": "RICHLANDS",
            "state": "VA",
            "postal_code": "246410279",
            "telephone_number": "276-964-6649",
            "fax_number": "276-964-5007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6719 GOVERNOR G.C. PEERY HWY",
            "address_2": "SUITE 2600",
            "city": "RICHLANDS",
            "state": "VA",
            "postal_code": "246410279",
            "telephone_number": "276-964-6649",
            "fax_number": "276-964-5007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAKKAR",
        "first_name": "MULJIBHAI",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2018-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "VA",
            "license": "0101031664",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0087219000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BLACK LUNG PROGRAM",
            "identifier": "011104800",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64661788",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED MINE WORKERS ASSOCIATION",
            "identifier": "1003658",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006088414",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "060108",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Betty Gail Street, M.S., CCC-SLP
• Suasin Cancer Care, Inc.
• Monica G Tague, CRNA
• Tahir Ahmed MD PC
• Fady Mamdouh Fayek Tawadros, M.D.
• The Woman's Group Richlands
• Thomas F. Bays, DDS, PC
• Sarah Elizabeth-Shea Thompson, MPT
• Roy Varghese Thomson, MD
• Ravi Kumar Titha, MD

• Specialist in Richlands, VA
• Providers in Richlands, VA by specialty
• Specialist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.