NPIMap

Organization Active NPI

Montgomery Medical

  • Internal Medicine Physician
  • Clarksville, TN
National Provider Identifier
1386837235
Registry record updated Jan 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
29412 Issued in TN
Legal business name
MONTGOMERY MEDICAL
Practice address
311 Landrum Place
#100
Clarksville, TN 37043
Phone
(931) 920-0228
Fax
(931) 920-2191
NPI assigned
Aug 23, 2007
Last updated
Jan 25, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2011

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

Authorized official

Name
Chandrakanta D Nawathe, MDNPI 1174536684
Title
Owner
Phone
(931) 920-0228

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 29412 TN Primary

Addresses

Primary practice location

311 Landrum Place
#100
Clarksville, TN 37043

Mailing address

P.O. Box 3479
Clarksville, TN 37043
Phone (931) 920-0228

National Provider Directory

National Provider Directory

Locations

311 Landrum Pl
#100
Clarksville, TN 37043
Phone (931) 920-0228

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1187827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295913600000",
    "number": "1386837235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 3479",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "37043",
            "telephone_number": "931-920-0228",
            "fax_number": "931-920-2191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 LANDRUM PLACE",
            "address_2": "#100",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "37043",
            "telephone_number": "931-920-0228",
            "fax_number": "931-920-2191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTGOMERY MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-23",
        "last_updated": "2011-01-25",
        "status": "A",
        "authorized_official_last_name": "NAWATHE",
        "authorized_official_first_name": "CHANDRAKANTA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "931-920-0228",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "29412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2011; 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.