Clarksville Cardiology PLLC

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

Legal business name

CLARKSVILLE CARDIOLOGY PLLC

Practice address

111 Center Pointe Dr Ste 2
Clarksville, TN 37040-8684

Phone

(931) 217-6648

NPI assigned

Apr 19, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Philip Thomas Madaelil, MDNPI 1487657722

Title

Cardiologist/Sole Owner

Phone

(931) 217-6648

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Philip Thomas Madaelil, M.D., F.A.C.C.

  • Cardiovascular Disease Physician
  • Clarksville, TN
  • NPI 1487657722
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1618790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620000000000",
    "number": "1699356816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 CENTER POINTE DR STE 2",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370408684",
            "telephone_number": "931-217-6648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 CENTER POINTE DR STE 2",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370408684",
            "telephone_number": "931-217-6648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARKSVILLE CARDIOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-19",
        "last_updated": "2021-05-03",
        "certification_date": "2021-05-03",
        "status": "A",
        "authorized_official_last_name": "MADAELIL",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "CARDIOLOGIST/SOLE OWNER",
        "authorized_official_telephone_number": "931-217-6648",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clarksville Dental Center, PLLC
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• Cardiovascular Disease Physician in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Cardiovascular Disease Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.