Individual provider Active NPI

David G Lavelle, M.D.

  • Orthopaedic Surgery Physician
  • Germantown, TN
National Provider Identifier
1356338040
Registry record updated May 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
12159 Issued in TN
Practice address
1400 S Germantown Rd
Germantown, TN 38138-2205
Phone
(901) 759-3100
NPI assigned
Sep 29, 2005
Last updated
May 1, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
3010903MedicaidTN
06286331MedicaidMS
109721001MedicaidAR

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101109000579 TN Practitioner - Orthopedic Surgery 5698830321 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12159TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
CC Bpci PLC Orthopaedic Surgery Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.