Individual provider Active NPI

Jacob Devolder

  • Internal Medicine Physician
  • Nashville, TN
National Provider Identifier
1427444058
Registry record updated Oct 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
57003 Issued in TN
Practice address
4220 Harding Pike Ste 500
Nashville, TN 37205-2005
Phone
(615) 322-0417
Fax
(615) 343-6119
NPI assigned
Apr 10, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 57003 TN Primary

Addresses

Primary practice location

4220 Harding Pike Ste 500
Nashville, TN 37205-2005

Mailing address

300 20TH Ave N Ste 403
Nashville, TN 37203-5180
Phone (615) 284-7224

Other identifiers 2

IdentifierTypeStateIssuer
Q037304MedicaidTN
T04514AOtherTNTN MEDICARE

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
I20181012001771 TN Practitioner - Internal MedicinePractitioner - Gastroenterology 0648572271 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Gastroenterology
Education
Vanderbilt University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Thomas Medical PartnersGroup PAC ID 1557269354, 588 clinicians

Practice addresses (Care Compare)

4220 Harding Rd
Suite 500
Nashville, TN 37205
Phone (615) 222-3449

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57003TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beaman Physician Services, PC CurrentSince Oct 31, 2023 Accepting new patients
Saint Thomas Medical Partners Internal Medicine CurrentSince Aug 1, 2018 Accepting new patients
Warner Physician Services PC CurrentSince Oct 31, 2023 Accepting new patients

Locations

300 20th Ave N
Fl 9
Nashville, TN 37203

4220 Harding Pike
Ste 500
Nashville, TN 37205
Phone (615) 222-2111

4220 Harding Pike
Nashville, TN 37205
Phone (615) 222-2111

300 20th Ave N
Ste 403
Nashville, TN 37203
Phone (615) 284-4088

2000 Church St
Nashville, TN 37236
Phone (615) 284-4672

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1428624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540771200000",
    "number": "1427444058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 20TH AVE N STE 403",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372035180",
            "telephone_number": "615-284-7224",
            "fax_number": "615-284-7501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4220 HARDING PIKE STE 500",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372052005",
            "telephone_number": "615-322-0417",
            "fax_number": "615-343-6119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVOLDER",
        "first_name": "JACOB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-10",
        "last_updated": "2018-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "57003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q037304",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TN MEDICARE",
            "identifier": "T04514A",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

Verify at the official NPI Registry.