Individual provider Active NPI

Nalini Samavedy, MD

  • Psychiatry Physician
  • Maryville, TN
National Provider Identifier
1629121447
Registry record updated Oct 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
43568 Issued in TN
Practice address
210 Simmons St
Maryville, TN 37801-4750
Phone
(865) 970-9800
Fax
(865) 374-7129
NPI assigned
Jan 18, 2007
Last updated
Oct 15, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 50641020 WI
Psychiatry Physician 2084P0800X 43568 TN Primary

Addresses

Primary practice location

210 Simmons St
Maryville, TN 37801-4750

Mailing address

1451 Dowell Springs Blvd
Knoxville, TN 37909-2441
Phone (865) 374-7123

Other identifiers 2

IdentifierTypeStateIssuer
34920300MedicaidWI
1509802MedicaidTN

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
I20081210000343 TN Practitioner - Psychiatry 6709979693 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Parkwest Medical CenterGroup PAC ID 8527965417, 58 clinicians

Practice addresses (Care Compare)

203 Corporate PL
Alcoa, TN 37701-1940
Phone (865) 970-9800

9352 Park W Blvd
Knoxville, TN 37923-4325
Phone (865) 694-5700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50641020WIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Parkwest Medical Center CurrentSince Oct 1, 2008 Accepting new patients
Parkwest Medical Center CurrentSince Oct 1, 2008 Accepting new patients
Parkwest Medical Center Past Accepting new patients
Prohealth Medical Group Inc Past Accepting new patients

Locations

9352 Park West Blvd
Knoxville, TN 37923
Phone (865) 373-1000

1451 Dowell Springs Blvd
Knoxville, TN 37909
Phone (865) 374-7123

210 Simmons St
Maryville, TN 37801
Phone (865) 374-7100

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350259200000",
    "number": "1629121447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1451 DOWELL SPRINGS BLVD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379092441",
            "telephone_number": "865-374-7123",
            "fax_number": "865-374-7129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 SIMMONS ST",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378014750",
            "telephone_number": "865-970-9800",
            "fax_number": "865-374-7129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMAVEDY",
        "first_name": "NALINI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2012-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "50641020",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TN",
            "license": "43568",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34920300",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1509802",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, TN

Sources for this page

Verify at the official NPI Registry.