Active NPI
Ronald T Zellem, MD
- Neurological Surgery Physician
- Hendersonville, TN
National Provider Identifier
1518908466
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurological Surgery Physician
- License
- 20953
- Practice address
- 119 Hidden PT
Hendersonville, TN 37075 - Phone
- (615) 944-3053
- Fax
- (615) 822-8032
- NPI assigned
- Jun 10, 2006
- Last updated
- Jul 19, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurological Surgery Physician | 207T00000X | 036126939 | IL | |
| Neurological Surgery Physician | 207T00000X | 20953 | TN | Primary |
Addresses
Primary practice location
119 Hidden PT
Hendersonville, TN 37075
Mailing address
242 W. Main Sreet
#233
Hendersonville, TN 37075
Phone (615) 944-3053
Other practice location 1
301 Madison St Ste 300
Joliet, IL 60435-6664
Phone (815) 725-4367
Other practice location 2
800 Austin St Ste 363
Evanston, IL 60202-3454
Phone (847) 316-7055
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3726268 | 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 |
|---|---|---|---|
| 036126939 | IL | MD | Neurological Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531958400000",
"number": "1518908466",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "242 W. MAIN SREET",
"address_2": "#233",
"city": "HENDERSONVILLE",
"state": "TN",
"postal_code": "37075",
"telephone_number": "615-944-3053",
"fax_number": "615-822-8032"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "119 HIDDEN PT",
"city": "HENDERSONVILLE",
"state": "TN",
"postal_code": "37075",
"telephone_number": "615-944-3053",
"fax_number": "615-822-8032"
}
],
"practiceLocations": [
{
"address_1": "301 Madison St Ste 300",
"address_purpose": "LOCATION",
"city": "Joliet",
"state": "IL",
"postal_code": "604356664",
"country_code": "US",
"telephone_number": "815-725-4367",
"fax_number": "815-725-4863",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "800 Austin St Ste 363",
"address_purpose": "LOCATION",
"city": "Evanston",
"state": "IL",
"postal_code": "602023454",
"country_code": "US",
"telephone_number": "847-316-7055",
"fax_number": "847-316-7056",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ZELLEM",
"first_name": "RONALD",
"middle_name": "T",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-10",
"last_updated": "2018-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "207T00000X",
"taxonomy_group": "",
"desc": "Neurological Surgery",
"state": "IL",
"license": "036126939",
"primary": false
},
{
"code": "207T00000X",
"taxonomy_group": "",
"desc": "Neurological Surgery",
"state": "TN",
"license": "20953",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3726268",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hendersonville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.