Individual provider Active NPI

Ashok V Mehta, MD

  • Pediatric Cardiology Physician
  • Johnson City, TN
National Provider Identifier
1477515880
Registry record updated Apr 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
MD017615 Issued in TN
Practice address
2312 Knob Creek Rd
Ste 208
Johnson City, TN 37604-2367
Phone
(423) 610-1099
Fax
(423) 610-1166
NPI assigned
Apr 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X MD017615 TN Primary

Addresses

Primary practice location

2312 Knob Creek Rd
Ste 208
Johnson City, TN 37604-2367

Mailing address

PO Box 3953
Johnson City, TN 37602-3953
Phone (423) 915-1126

Other identifiers 1

IdentifierTypeStateIssuer
3023510MedicaidTN

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
MD017615TNMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Allergy & Asthma Center, PC PastSince Jan 1, 2006 Accepting new patients
Johnston Memorial Hospital, Inc Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333670400000",
    "number": "1477515880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3953",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376023953",
            "telephone_number": "423-915-1126",
            "fax_number": "423-915-0635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2312 KNOB CREEK RD",
            "address_2": "STE 208",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042367",
            "telephone_number": "423-610-1099",
            "fax_number": "423-610-1166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "ASHOK",
        "middle_name": "V",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-03",
        "last_updated": "2012-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "TN",
            "license": "MD017615",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3023510",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2012; 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.