Active NPI
Nick Tkeshelashvili, M.D.
- Vascular-Interventional Technology Radiologic Technologist
- Baltimore, MD
National Provider Identifier
1699945196
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular-Interventional Technology Radiologic Technologist
- Practice address
- 1301 Aliceanna St Apt 1811
Baltimore, MD 21231-3270 - Phone
- (443) 870-3750
- Fax
- (443) 870-3754
- NPI assigned
- Mar 11, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular-Interventional Technology Radiologic Technologist | 2471V0106X | Primary |
Addresses
Primary practice location
1301 Aliceanna St Apt 1811
Baltimore, MD 21231-3270
Mailing address
1301 Aliceanna St Apt 1811
Baltimore, MD 21231-3270
Phone (443) 870-3750
Other practice location 1
23 Greenspring Valley Rd
Owings Mills, MD 21117-4101
Phone (443) 870-3750
Other practice location 2
6518 Deer Park Rd
Reisterstown, MD 21136
Phone (443) 870-3750
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sonoscan LLC | Vascular-Interventional Technology | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205193600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603238400000",
"number": "1699945196",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1301 ALICEANNA ST APT 1811",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212313270",
"telephone_number": "443-870-3750",
"fax_number": "443-870-3754"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 ALICEANNA ST APT 1811",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212313270",
"telephone_number": "443-870-3750",
"fax_number": "443-870-3754"
}
],
"practiceLocations": [
{
"address_1": "23 Greenspring Valley Rd",
"address_purpose": "LOCATION",
"city": "Owings Mills",
"state": "MD",
"postal_code": "211174101",
"country_code": "US",
"telephone_number": "443-870-3750",
"fax_number": "443-870-3754",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "6518 DEER PARK RD",
"address_purpose": "LOCATION",
"city": "REISTERSTOWN",
"state": "MD",
"postal_code": "21136",
"country_code": "US",
"telephone_number": "443-870-3750",
"fax_number": "443-870-3754",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TKESHELASHVILI",
"first_name": "NICK",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-03-11",
"last_updated": "2020-10-21",
"certification_date": "2020-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "2471V0106X",
"taxonomy_group": "",
"desc": "Radiologic Technologist, Vascular-Interventional Technology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.