Mahmood a Siddiqui MD PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD26174 Issued in TN

Legal business name

MAHMOOD A SIDDIQUI MD PC

Practice address

144 Medical Center Dr. #B
Copperhill, TN 37317-5000

Phone

(423) 496-9214

Fax

(423) 496-7809

NPI assigned

Jul 25, 2006

Last updated

Nov 9, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mahmood Abdul Siddiqui, M.D.NPI 1568439453

Title

President

Phone

(423) 496-9214

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 16

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.

• Mahmood Abdul Siddiqui, M.D.

  • Internal Medicine Physician
  • Copperhill, TN
  • NPI 1568439453
  Medicare reassignment Care Compare group NPD Authorized official
• Kayla Marie Holder, APN

  • Family Nurse Practitioner
  • Copperhill, TN
  • NPI 1558182261
  Medicare reassignment Care Compare group NPD
• John Franklin Samples, FNP-BC

  • Family Nurse Practitioner
  • Copperhill, TN
  • NPI 1518325463
  Medicare reassignment Care Compare group NPD
• Donna Robinson

  • Family Nurse Practitioner
  • Cleveland, TN
  • NPI 1316365554
  Medicare reassignment NPD
• Lisa Condra Swafford

  • Primary Care Nurse Practitioner
  • Chattanooga, TN
  • NPI 1518420256
  Medicare reassignment NPD
• Kayla Renee Boggs, FNP-C

  • Nurse Practitioner
  • Blue Ridge, GA
  • NPI 1326811258

  TN

  Medicare reassignment NPD
• Stacie Nelson, NP

  • Acute Care Nurse Practitioner
  • Temple, TX
  • NPI 1164518502

  TN

  Medicare reassignment NPD
• Jessica Ella Collins, PA-C

  • Physician Assistant
  • Copperhill, TN
  • NPI 1760433288
  Medicare reassignment
• Eric Lee Satterfield, D.O.

  • Family Medicine Physician
  • Copperhill, TN
  • NPI 1912052655
  NPD
• Tyler Russell Archer, MSN, NP-C

  • Family Nurse Practitioner
  • Cleveland, TN
  • NPI 1548770944
  NPD (past)
• Jateum Mauree Blackburn, FNP-C

  • Family Nurse Practitioner
  • Cleveland, TN
  • NPI 1265818983
  NPD (past)
• Saundra M Bosche, RN/NP

  • Family Nurse Practitioner
  • Memphis, TN
  • NPI 1699752311
  NPD (past)

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194566400000",
    "number": "1427070523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1162",
            "city": "COPPERHILL",
            "state": "TN",
            "postal_code": "373171162",
            "telephone_number": "423-496-9214",
            "fax_number": "423-496-7809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 MEDICAL CENTER DR. #B",
            "city": "COPPERHILL",
            "state": "TN",
            "postal_code": "373175000",
            "telephone_number": "423-496-9214",
            "fax_number": "423-496-7809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAHMOOD A SIDDIQUI MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-11-09",
        "status": "A",
        "authorized_official_last_name": "SIDDIQUI",
        "authorized_official_first_name": "MAHMOOD",
        "authorized_official_middle_name": "ABDUL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "423-496-9214",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD26174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3736177",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Grace Health Services PLLC
• Mary F. Haire, R.N.
• Ronald G Hensley
• Kayla Marie Holder, APN
• Kayla Yolanda Hughes, R.N.
• Lester Dale McCartney, M.D.
• Claude Dennis Muse, DDS
• Ocoee Emergency Physicians
• Ocoee Regional Health Corporation (Copper Basin Elementary School)
• Patricia A Padgett, LPN

• Internal Medicine Physician in Copperhill, TN
• Providers in Copperhill, TN by specialty
• Internal Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.