Kadallah Zizwee Brandy
Individual provider Active NPI Internal Medicine Physician · Gallup, NM
NPI 1689839482 · NPPES record last updated Aug 15, 2011
Key facts
- NPI
- 1689839482
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 46860 (TN)
- Practice address
- 516 East Nizhoni Blvd.
Gallup, NM 87301-1337 - Phone
- (505) 722-1000
- Fax
- (505) 726-8557
- NPI assigned
- Jul 22, 2008
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 12
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Meharry Medical College School of Medicine, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Hospital Medicine Services of TN LLC
Practice addresses (Care Compare)
2300 Patterson St
Nashville, TN 37203-1538
Phone (615) 342-1000
2333 McCallie Ave
Chattanooga, TN 37404-3258
Phone (423) 698-6061
5655 1St Blvd
Hermitage, TN 37076-2053
Phone (615) 316-3000
941 Spring Creek Rd
Chattanooga, TN 37412-3909
Phone (423) 894-7870
Hospital & facility affiliations
- Atrium Health Navicent the Medical Center
- Parkridge Medical Center
- Tristar Summit Medical Center
- Savannah Health Services LLC Dba Memorial Health University Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TN, GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110805000652 | TN | Practitioner - Internal Medicine | 0446429542 | Reassigns benefits to 5 organizations |
| I20160801000243 | GA | Practitioner - Internal Medicine | 0446429542 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeastern Physician Services PC | Internal Medicine | Current |
Accepting new patients |
| Summit Medical Group, PLLC | Current |
Accepting new patients | |
| Allatoona Physician Services PC | Current |
Accepting new patients | |
| Hospital Medicine Services of TN, LLC | Current |
Accepting new patients | |
| Hardy Renew Wellness,LLC | Internal Medicine | Current |
Accepting new patients |
| Apogee Medical Group Tennessee PC | Internal Medicine | Current |
Accepting new patients |
| Hospital Physician Services - Southeast Professional Corporation | Current |
Accepting new patients | |
| West Tennessee Healthcare Hospitalists Inc | Current |
Accepting new patients | |
| Parkridge Medical Center, Inc. | Past | Accepting new patients | |
| Emory Specialty Associates, LLC | Internal Medicine | Past | Accepting new patients |
| The Medical Center of Central Georgia Inc | Past | Accepting new patients |
Locations
960 Joe Frank Harris Pkwy SE
Cartersville, GA 30120
Phone (404) 554-2196
501 Redmond Rd NW
Rome, GA 30165
Phone (706) 291-0291
1900 Tebeau St
Waycross, GA 31501
Phone (912) 283-3030
2333 McCallie Ave
Chattanooga, TN 37404
Phone (423) 493-1387
2305 Chambliss Ave NW
Cleveland, TN 37311
Phone (423) 559-6000
941 Spring Creek Rd
East Ridge, TN 37412
Phone (423) 855-3255
355 New Shackle Island Rd
Hendersonvlle, TN 37075
Phone (615) 264-4000
5655 Frist Blvd
Hermitage, TN 37076
Phone (615) 316-3541
620 Skyline Dr
Jackson, TN 38301
Phone (731) 541-4923
1804 Highway 45 Byp
Ste 604
Jackson, TN 38305
Phone (731) 512-1273
1000 Highway 28
Jasper, TN 37347
Phone (423) 837-9500
1225 E Weisgarber Rd
Ste 200
Knoxville, TN 37909
Phone (865) 938-3627
1607 S Locust Ave
Lawrenceburg, TN 38464
Phone (731) 287-2244
2300 Patterson St
#M
Nashville, TN 37203
2300 Patterson St
Nashville, TN 37203
Phone (615) 342-1500
7565 Dannaher Dr
Powell, TN 37849
Phone (865) 545-8000
1201 Bishop St
Union City, TN 38261
Phone (423) 698-6061
Interoperability endpoints
- kbrandy3022687@carolinashealthcaresystem.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 46860 | TN | Yes |
Addresses
Primary practice location
516 East Nizhoni Blvd.
Gallup, NM 87301-1337
Mailing address
P.O. Box 1337
Gallup, NM 87305-1337
Phone (505) 722-1000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| VAD000 | Other | TN | FEDERAL UPIN |
Other providers in Gallup, NM
- Barbara Jean Bradley
- Melba G Brafford
- Ashley Brain
- Tamara Deanne Brand
- Laura Nicole Brandon
- Ray Harris Branson
- George Brasinikas
- Chen Brautigan
- Frances Marie Bravo
- Cleo Brazier
All providers in Gallup, NM · Internal Medicine Physician in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 15, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.