Individual provider Active NPI

Vadankumar Manibhai Patel, MD

  • Psychiatry Physician
  • Jackson, TN
National Provider Identifier
1538100730
Registry record updated Mar 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
25785 Issued in TN
Practice address
238 Summar Dr
Jackson, TN 38301-3906
Phone
(731) 935-8200
Fax
(731) 935-8327
NPI assigned
Jun 9, 2006
Last updated
Mar 10, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 25785 TN Primary

Addresses

Primary practice location

238 Summar Dr
Jackson, TN 38301-3906

Mailing address

1804 Highway 45 Byp
Suite 604
Jackson, TN 38305-4436
Phone (731) 660-8759

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, CO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040105000067 TN Practitioner - Psychiatry 4082519129 Reassigns benefits to 2 organizations
Practice locations: Martin, TN
I20230724004127 CO Practitioner - Psychiatry 4082519129 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25785TNMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aspen Valley Hospital Clinics, PLLC Current Accepting new patients
Henry County Medical Center CurrentSince Jan 1, 2020 Accepting new patients
Aspen Valley Hospital District Clinics CurrentSince Jul 1, 2023 Accepting new patients
Baptist Memorial Hospital- Union City Inc CurrentSince Feb 1, 1999 Accepting new patients
Baptist Memorial Hospital-Union City Inc Current Accepting new patients
Aspen Valley Hospital District CurrentSince Jul 1, 2023 Accepting new patients
Henry County Medical Center CurrentSince Jan 1, 2020 Accepting new patients
Aspen Valley Hospital District CurrentSince Jul 1, 2023 Accepting new patients

Locations

401 Castle Creek Rd
Aspen, CO 81611
Phone (970) 544-1192

1460 E Valley Rd
Ste 103
Basalt, CO 81621
Phone (970) 279-4111

301 Tyson Ave
Paris, TN 38242
Phone (731) 642-1220

1201 Bishop St
Union City, TN 38261
Phone (423) 698-6061

Interoperability endpoints

  • FHIR API: https://epicproxy.et1254.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.240000
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.240001

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268179200000",
    "number": "1538100730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 HIGHWAY 45 BYP",
            "address_2": "SUITE 604",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383054436",
            "telephone_number": "731-660-8759",
            "fax_number": "731-660-8739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "238 SUMMAR DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013906",
            "telephone_number": "731-935-8200",
            "fax_number": "731-935-8327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "VADANKUMAR",
        "middle_name": "MANIBHAI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2010-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TN",
            "license": "25785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.