Individual provider Active NPI

Joe M Chisholm, MD

  • Ophthalmology Physician
  • Nashville, TN
National Provider Identifier
1407886955
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
TN007758 Issued in TN
Practice address
2010 Church St
Mid State Medical Center Suite 705
Nashville, TN 37203-2012
Phone
(615) 329-7930
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X TN007758 TN Primary

Addresses

Primary practice location

2010 Church St
Mid State Medical Center Suite 705
Nashville, TN 37203-2012

Mailing address

2010 Church St
Mid State Medical Center Suite 705
Nashville, TN 37203-2012
Phone (615) 329-7930

Other identifiers 3

IdentifierTypeStateIssuer
OP34422OtherUNITED HEALTHCARE
0025540OtherBLUE CROSS
CSP053OtherCIGNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TN007758TNMDOphthalmology Physician

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407886955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 CHURCH ST",
            "address_2": "MID STATE MEDICAL CENTER SUITE 705",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372032012",
            "telephone_number": "615-329-7930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 CHURCH ST",
            "address_2": "MID STATE MEDICAL CENTER SUITE 705",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372032012",
            "telephone_number": "615-329-7930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHISHOLM",
        "first_name": "JOE",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TN",
            "license": "TN007758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "OP34422",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0025540",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "CSP053",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.