Active NPI
Ashok V Mehta, MD
- Pediatric Cardiology Physician
- Johnson City, TN
National Provider Identifier
1477515880
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Cardiology Physician
- License
- MD017615
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3023510 | Medicaid | TN |
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
| License | State | Type | Specialty |
|---|---|---|---|
| MD017615 | TN | MD | Pediatric Cardiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Regional Allergy & Asthma Center, PC | Past | 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.
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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.