Individual provider Active NPI

Venkatachalam Ayyagari, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Bartlett, TN
National Provider Identifier
1508875733
Registry record updated Aug 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
MD 8772 Issued in TN
Practice address
2784 Bartlett Blvd
Bartlett, TN 38134-4530
Phone
(901) 382-9998
Fax
(901) 382-9998
NPI assigned
Aug 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD 8772 TN
Endocrinology, Diabetes & Metabolism Physician 207RE0101X MD 8772 TN Primary

Addresses

Primary practice location

2784 Bartlett Blvd
Bartlett, TN 38134-4530

Mailing address

2784 Bartlett Blvd
Bartlett, TN 38134-4530
Phone (901) 382-9998

Other identifiers 1

IdentifierTypeStateIssuer
3181632MedicaidTN

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
I20150901003249 TN Practitioner - Internal MedicinePractitioner - Endocrinology 7315253630 Practice locations: Bartlett, TN

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Endocrinology
Education
Other, 1967
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2784 Bartlett Blvd
Bartlett, TN 38134-4530
Phone (901) 382-9998

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD 8772TNMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312243200000",
    "number": "1508875733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2784 BARTLETT BLVD",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381344530",
            "telephone_number": "901-382-9998",
            "fax_number": "901-382-9998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2784 BARTLETT BLVD",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381344530",
            "telephone_number": "901-382-9998",
            "fax_number": "901-382-9998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYYAGARI",
        "first_name": "VENKATACHALAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2011-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD 8772",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "TN",
            "license": "MD 8772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3181632",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bartlett, TN

Sources for this page

Verify at the official NPI Registry.