Individual provider Active NPI

Ashish Maheshkumar Bhakta, MD

  • Family Medicine Physician
  • Jackson, TN
National Provider Identifier
1598021867
Registry record updated Mar 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
53386 Issued in TN
Practice address
620 Skyline Dr
Jackson, TN 38301-3923
Phone
(731) 541-5000
NPI assigned
Apr 11, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 53386 TN Primary
Emergency Medicine Physician 207P00000X 53386 TN

Addresses

Primary practice location

620 Skyline Dr
Jackson, TN 38301-3923

Mailing address

13 Alderbrook LN
Jackson, TN 38305-1882

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20161213001418 GA Practitioner - Emergency MedicinePractitioner - Family Practice 7618115858 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Coverage LLCGroup PAC ID 3072412592, 761 clinicians

Practice addresses (Care Compare)

1360 S Main St
Ellijay, GA 30540-5410
Phone (706) 635-5111

Hospital & facility affiliations

  • Piedmont Mountainside Hospital Inc Hospital, Jasper, GA, CCN 110225

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53386TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
WT University Medical Associates Inc Family Medicine Current Accepting new patients

Locations

294 Summar Dr
Jackson, TN 38301
Phone (731) 423-1932

620 Skyline Dr
Jackson, TN 38301
Phone (731) 541-4923

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1334102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457568000000",
    "number": "1598021867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 ALDERBROOK LN",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383051882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 SKYLINE DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013923",
            "telephone_number": "731-541-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHAKTA",
        "first_name": "ASHISH",
        "middle_name": "MAHESHKUMAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-11",
        "last_updated": "2016-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "53386",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "53386",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.