Active NPI
David G Lavelle, M.D.
- Orthopaedic Surgery Physician
- Germantown, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 12159
- Practice address
- 1400 S Germantown Rd
Germantown, TN 38138-2205 - Phone
- (901) 759-3100
- NPI assigned
- Sep 29, 2005
- Last updated
- May 1, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 12159 | TN | Primary |
Addresses
Primary practice location
1400 S Germantown Rd
Germantown, TN 38138-2205
Mailing address
1400 S Germantown Rd
Germantown, TN 38138-2205
Phone (901) 759-3100
Other practice location 1
7545 Airways Blvd
Southaven, MS 38671-5806
Phone (901) 759-3100
Other practice location 2
8000 Centerview Pkwy Ste 500
Cordova, TN 38018-4254
Phone (901) 759-3100
Other practice location 3
1458 W Poplar Ave Ste 100
Collierville, TN 38017-0630
Phone (901) 759-3100
Other practice location 4
1211 Union Ave Ste 500
Memphis, TN 38104-6656
Phone (901) 759-3100
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3010903 | Medicaid | TN | |
| 06286331 | Medicaid | MS | |
| 109721001 | Medicaid | AR |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12159 | TN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CC Bpci PLC | Orthopaedic Surgery | Past | Accepting new patients |
Interoperability endpoints
- dlavelle@cco1043.srs-direct.com
Organizations & group practices 2
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.
-
- Orthopaedic Surgery Physician
- Germantown, TN
- NPI 1003835141
-
- Orthopaedic Surgery Physician
- Germantown, TN
- NPI 1881387330
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525132800000",
"number": "1356338040",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 S GERMANTOWN RD",
"city": "GERMANTOWN",
"state": "TN",
"postal_code": "381382205",
"telephone_number": "901-759-3100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 S GERMANTOWN RD",
"city": "GERMANTOWN",
"state": "TN",
"postal_code": "381382205",
"telephone_number": "901-759-3100"
}
],
"practiceLocations": [
{
"address_1": "7545 Airways Blvd",
"address_purpose": "LOCATION",
"city": "Southaven",
"state": "MS",
"postal_code": "386715806",
"country_code": "US",
"telephone_number": "901-759-3100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "8000 Centerview Pkwy Ste 500",
"address_purpose": "LOCATION",
"city": "Cordova",
"state": "TN",
"postal_code": "380184254",
"country_code": "US",
"telephone_number": "901-759-3100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1458 W Poplar Ave Ste 100",
"address_purpose": "LOCATION",
"city": "Collierville",
"state": "TN",
"postal_code": "380170630",
"country_code": "US",
"telephone_number": "901-759-3100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1211 Union Ave Ste 500",
"address_purpose": "LOCATION",
"city": "Memphis",
"state": "TN",
"postal_code": "381046656",
"country_code": "US",
"telephone_number": "901-759-3100",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LAVELLE",
"first_name": "DAVID",
"middle_name": "G",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-29",
"last_updated": "2018-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "TN",
"license": "12159",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3010903",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "06286331",
"state": "MS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "109721001",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Germantown, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2018; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.