Active NPI
Zandra Renee Petway MD,PC
- General Practice Physician
- Nashville, TN
National Provider Identifier
1669646576
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 27699
- Legal business name
- ZANDRA RENEE PETWAY MD,PC
- Practice address
- 457 Donelson Pike
Nashville, TN 37214-3561 - Phone
- (615) 884-0215
- NPI assigned
- Apr 22, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Zandra R Petway, M.D.,
- Title
- Owner
- Phone
- (615) 884-0215
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 27699 | TN | Primary |
Addresses
Primary practice location
457 Donelson Pike
Nashville, TN 37214-3561
Mailing address
PO Box 2018
Brentwood, TN 37024-2018
Phone (615) 884-0215
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4010427 | Other | TN | BLUECROSS BLUESHIELD |
| 3802977 | Medicaid | TN |
National Provider Directory
National Provider Directory- Tax ID family
- Christian Family Medical Clinic PC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Primary Care Clinic/Center
- Nashville, TN
- NPI 1952632531
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- General Practice Physician
- Brentwood, TN
- NPI 1265447619
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208822400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1208822400000",
"number": "1669646576",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2018",
"city": "BRENTWOOD",
"state": "TN",
"postal_code": "370242018",
"telephone_number": "615-884-0215"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "457 DONELSON PIKE",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372143561",
"telephone_number": "615-884-0215"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ZANDRA RENEE PETWAY MD,PC",
"organizational_subpart": "NO",
"enumeration_date": "2008-04-22",
"last_updated": "2008-04-22",
"status": "A",
"authorized_official_last_name": "PETWAY",
"authorized_official_first_name": "ZANDRA",
"authorized_official_middle_name": "R",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "615-884-0215",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D.,"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "General Practice",
"state": "TN",
"license": "27699",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS BLUESHIELD",
"identifier": "4010427",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3802977",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Nashville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.