Individual provider Active NPI

Farid Abdulrehman Thanawalla, M.D.

  • Vascular & Interventional Radiology Physician
  • Goodlettsville, TN
National Provider Identifier
1770558496
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
54593 Issued in TN
Practice address
919 Conference Dr Ste 4
Goodlettsville, TN 37072-1924
Phone
(615) 788-9324
NPI assigned
Feb 17, 2006
Last updated
Aug 31, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2026

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

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 56250 CO
Diagnostic Radiology Physician 2085R0202X 24890 NE
Diagnostic Radiology Physician 2085R0202X 217086 MA
Diagnostic Radiology Physician 2085R0202X MD18855 HI
Diagnostic Radiology Physician 2085R0202X 04-39312 KS
Vascular & Interventional Radiology Physician 2085R0204X 79558 GA
Vascular & Interventional Radiology Physician 2085R0204X 54593 TN Primary
Vascular & Interventional Radiology Physician 2085R0204X 217086 MA
Vascular & Interventional Radiology Physician 2085R0204X 24890 NE

Addresses

Primary practice location

919 Conference Dr Ste 4
Goodlettsville, TN 37072-1924

Mailing address

919 Conference Dr
Suite #4, Box 167
Goodlettsville, TN 37072-1924
Phone (615) 788-9324

Other identifiers 11

IdentifierTypeStateIssuer
1770558496MedicaidSD
87881730MedicaidNM
$$$$$$$$$MedicaidNE
2015757MedicaidMA
1770558496MedicaidIA
82653844MedicaidCO
200659440AMedicaidOK
191281MedicaidAZ
201141130AMedicaidKS
A35829OtherMAMEDICARE ID
1770558496MedicaidMT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, IN, NY, TN, IL, FL, GA, AR8 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 8

Enrollment IDStateProvider typePAC IDDetails
I20090225000558 NE Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 5698688612
I20181109002525 IN Practitioner - Diagnostic Radiology 5698688612 Reassigns benefits to 1 organization
I20190220000747 NY Practitioner - Diagnostic Radiology 5698688612
I20200720000306 TN Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 5698688612 Reassigns benefits to 7 organizations
I20210322000218 IL Practitioner - Diagnostic Radiology 5698688612 Reassigns benefits to 1 organization
I20240202001695 FL Practitioner - Diagnostic Radiology 5698688612
I20250617003947 GA Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 5698688612 Reassigns benefits to 2 organizations
I20251013003372 AR Practitioner - Diagnostic Radiology 5698688612 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional RadiologyAlso: Diagnostic Radiology
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metropolitan Hospital AuthorityGroup PAC ID 3779775432, 50 clinicians
Dynamic Radiology Tennessee PCGroup PAC ID 6204207798, 5 clinicians

Practice addresses (Care Compare)

110 31St Ave N
Apt 502
Nashville, TN 37203-1576
Phone (270) 796-5541

1818 Albion St
Nashville, TN 37208-2918
Phone (615) 341-4000

305 W Locust St
Lafayette, TN 37083-1712
Phone (615) 666-2147

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
56250COMDDiagnostic Radiology Physician
MD18855HIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vista Radiology, PC. Diagnostic Radiology CurrentSince Jun 1, 2025 Accepting new patients
St Bernards Hospital Inc. CurrentSince Oct 3, 2025 Accepting new patients
Phoebe Physician Group, Inc CurrentSince Apr 1, 2025 Accepting new patients
Dynamic Radiology Tennessee, PC Diagnostic Radiology CurrentSince Sep 9, 2022 Accepting new patients
Metropolitan Hospital Authority CurrentSince Aug 3, 2020 Accepting new patients
Nashville Healthcare Diagnostic Center, LLC CurrentSince Aug 1, 2024 Accepting new patients
Radiology Alliance PC Diagnostic Radiology CurrentSince Mar 23, 2024 Accepting new patients
Phoebe Primary Care CurrentSince Apr 1, 2025 Accepting new patients
Regional West Medical Center Diagnostic Radiology CurrentSince Jun 12, 2024 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Wachusett Radiology, Inc. Diagnostic Radiology Past Accepting new patients
Gunnison Valley Hospital Diagnostic Radiology Past Accepting new patients
Saint Francis Medical Center Past Accepting new patients
Androscoggin Valley Hospital Inc Family Medicine Past Accepting new patients
White River Imaging, LLC Diagnostic Radiology Past Accepting new patients
Umass Memorial Medical Group Inc Family Medicine Past Accepting new patients
Ozarks Medical Center Family Medicine Past Accepting new patients
Grand Island Radiology Associates PC Diagnostic Radiology Past Accepting new patients
Regional West Physicians Clinic Past Accepting new patients

Locations

1201 Fleming Ave
Jonesboro, AR 72401
Phone (870) 932-0440

225 E Washington Ave
Jonesboro, AR 72401
Phone (870) 207-1630

2002 Palmyra Rd
Ste 201
Albany, GA 31701
Phone (229) 312-5802

151 Mayo St
Ste B
Americus, GA 31709
Phone (229) 928-2900

1211 Old Main St
Hartford, KY 42347
Phone (270) 298-3806

1100 W 2nd St
Oshkosh, NE 69154
Phone (308) 772-3283

3911 Avenue B
Ste 1100
Scottsbluff, NE 69361
Phone (308) 630-1355

4021 Avenue B
Scottsbluff, NE 69361
Phone (308) 630-1384

1325 Highway 76
Clarksville, TN 37043
Phone (931) 358-6600

651 Dunlop Ln
Clarksville, TN 37040
Phone (931) 502-1000

3310 Aspen Grove Dr
Ste 203
Franklin, TN 37067
Phone (615) 771-8274

919 Conference Dr
Ste 4
Goodlettsvlle, TN 37072
Phone (615) 788-9324

Dept 888302
Knoxville, TN 37995

305 W Locust St
Lafayette, TN 37083
Phone (615) 666-2147

1818 Albion St
Nashville, TN 37208
Phone (615) 341-4000

210 25th Ave N
Ste 1204
Nashville, TN 37203
Phone (615) 312-1479

4007 Clarksville Pike
Nashville, TN 37218
Phone (615) 341-4968

4007 Clarksville Pike
Ste 100
Nashville, TN 37218
Phone (615) 341-4000

Interoperability endpoints

  • Direct secure messaging: fthanawa@yourcarecommunity.org

Organizations & group practices 23

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 23

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

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    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788134400000",
    "number": "1770558496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 CONFERENCE DR",
            "address_2": "SUITE #4, BOX 167",
            "city": "GOODLETTSVILLE",
            "state": "TN",
            "postal_code": "370721924",
            "telephone_number": "615-788-9324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 CONFERENCE DR STE 4",
            "city": "GOODLETTSVILLE",
            "state": "TN",
            "postal_code": "370721924",
            "telephone_number": "615-788-9324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THANAWALLA",
        "first_name": "FARID",
        "middle_name": "ABDULREHMAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A"
    },
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            "primary": false
        },
        {
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            "taxonomy_group": "",
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            "license": "04-39312",
            "primary": false
        },
        {
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            "taxonomy_group": "",
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            "state": "GA",
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            "primary": false
        },
        {
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    "endpoints": [],
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}

Other providers in Goodlettsville, TN

Sources for this page

Verify at the official NPI Registry.