Active NPI
Deborah J Kondis, MD
- Gynecology Physician
- Nashville, TN
National Provider Identifier
1750362711
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gynecology Physician
- License
- MD17301
- Practice address
- 2011 Church St
Suite 403
Nashville, TN 37203-2000 - Phone
- (615) 284-6555
- Fax
- (615) 284-6558
- NPI assigned
- Nov 8, 2005
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Gynecology Physician | 207VG0400X | MD17301 | TN | Primary |
Addresses
Primary practice location
2011 Church St
Suite 403
Nashville, TN 37203-2000
Mailing address
2011 Church St
Suite 403
Nashville, TN 37203-2000
Phone (615) 284-6555
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 160026801 | Medicaid | TN | |
| 3009669 | Other | TN | BCBS |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD17301 | TN | MD | Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1263254400000",
"number": "1750362711",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2011 CHURCH ST",
"address_2": "SUITE 403",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372032000",
"telephone_number": "615-284-6555",
"fax_number": "615-284-6558"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2011 CHURCH ST",
"address_2": "SUITE 403",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372032000",
"telephone_number": "615-284-6555",
"fax_number": "615-284-6558"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KONDIS",
"first_name": "DEBORAH",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-11-08",
"last_updated": "2010-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "207VG0400X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Gynecology",
"state": "TN",
"license": "MD17301",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "160026801",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "3009669",
"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 Jan 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.