Genesis Heart and Vascular Associates, PLLC

Key facts

NPI: 1376916932
Entity type: Organization (NPI type 2)
Primary specialty: Cardiovascular Disease Physician 207RC0000X
Legal business name: GENESIS HEART AND VASCULAR ASSOCIATES, PLLC
Practice address: 120 Hospital Dr Ste 260
Jefferson City, TN 37760-5283
Phone: (423) 839-2525
Fax: (423) 839-2424
NPI assigned: Nov 4, 2015
Organization subpart: No

Authorized official

Name: Dr. Pragnesh Patel, MD NPI 1568529006
Title: Owner
Phone: (732) 966-2257

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Pragnesh A Patel, M.D. Interventional Cardiology Physician · Jefferson City, TN · NPI 1568529006

Medicare reassignment Care Compare group NPD Authorized official CARDIOVASCULAR DISEASE · TN
Hanna-Rae Nikohl Green, NP Family Nurse Practitioner · Jefferson City, TN · NPI 1568024396

Medicare reassignment Care Compare group NPD TN

Medicare participation

Medicare fee-for-service enrollment: Enrolled in TN

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20151218001448	TN	Part B Supplier - Clinic/Group Practice	6406157320	Receives reassigned benefits from 2 practitioners Practice locations: Newport, TN; Jefferson City, TN

National Provider Directory

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Cardiovascular Disease Physician Group: 193400000X SINGLE SPECIALTY GROUP	207RC0000X			Yes

Addresses

Primary practice location

120 Hospital Dr Ste 260
Jefferson City, TN 37760-5283

Mailing address

120 Hospital Dr Ste 260
Jefferson City, TN 37760-5283
Phone (423) 839-2525

Other practice location 1

434 4th St Ste 301
Newport, TN 37821-3735
Phone (423) 839-2525

Other providers in Jefferson City, TN

All providers in Jefferson City, TN · Cardiovascular Disease Physician in Tennessee

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 7, 2023. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.