Individual provider Active NPI

Ashish B Madhok, MD

  • Pediatric Cardiology Physician
  • Johnson City, TN
National Provider Identifier
1376533489
Registry record updated Jun 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
39874 Issued in TN
Practice address
2312 Knob Creek Rd
Suite208
Johnson City, TN 37604-2367
Phone
(423) 610-1099
Fax
(423) 610-1166
NPI assigned
Oct 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X 39874 TN Primary

Addresses

Primary practice location

2312 Knob Creek Rd
Suite208
Johnson City, TN 37604-2367

Mailing address

2312 Knob Creek Rd
Suite208
Johnson City, TN 37604-2367
Phone (423) 610-1099

Other identifiers 1

IdentifierTypeStateIssuer
02547560MedicaidTN

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
I20050726001087 TN Practitioner - Pediatric Medicine 9436058922 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2312 Knob Creek Rd
Johnson City, TN 37604-2367
Phone (423) 610-1099

935 Wilcox CT
Suite 150
Kingsport, TN 37660-5183
Phone (423) 246-1400

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39874TNMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-City Pediactric Cardiology P C Pediatric Cardiology CurrentSince Jan 1, 2009 Accepting new patients
Regional Allergy & Asthma Center, PC PastSince Jan 1, 2006 Accepting new patients
Johnston Memorial Hospital, Inc Past Accepting new patients

Locations

2312 Knob Creek Rd
Ste 208
Johnson City, TN 37604
Phone (423) 246-6445

935 Wilcox Ct
Ste 150
Kingsport, TN 37660
Phone (423) 246-1400

16000 Johnston Memorial Dr
Abingdon, VA 24211
Phone (276) 258-1000

16000 Johnston Memorial Dr
Ste 212A
Abingdon, VA 24211
Phone (276) 258-1000

1490 Park Ave NW
Ste 4B2
Norton, VA 24273

Organizations & group practices 3

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": "1130457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212624000000",
    "number": "1376533489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2312 KNOB CREEK RD",
            "address_2": "SUITE208",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042367",
            "telephone_number": "423-610-1099",
            "fax_number": "423-610-1166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2312 KNOB CREEK RD",
            "address_2": "SUITE208",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042367",
            "telephone_number": "423-610-1099",
            "fax_number": "423-610-1166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADHOK",
        "first_name": "ASHISH",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-28",
        "last_updated": "2008-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "TN",
            "license": "39874",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02547560",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.