Individual provider Active NPI

Khyati Nirmit Kothari, MD

  • Psychiatry Physician
  • Memphis, TN
National Provider Identifier
1801102330
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
53556 Issued in TN
Practice address
1068 Cresthaven Rd Ste 500
Memphis, TN 38119-0846
Phone
(901) 448-2400
Fax
(901) 302-2420
NPI assigned
Aug 21, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 53556 TN Primary

Addresses

Primary practice location

1068 Cresthaven Rd Ste 500
Memphis, TN 38119-0846

Mailing address

1068 Cresthaven Rd Ste 300
Memphis, TN 38119-0809
Phone (901) 866-8864

Other identifiers 3

IdentifierTypeStateIssuer
008452266MedicaidMS
213682001MedicaidAR
Q021386MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20160407001415 TN Practitioner - Psychiatry 7214152610 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ut Medical Group IncGroup PAC ID 3173435369, 98 clinicians

Practice addresses (Care Compare)

1068 Cresthaven Rd
Suite 500
Memphis, TN 38119-0846
Phone (901) 866-8805

Merit-based Incentive Payment System (MIPS)

Final score
88.15 of 100Reported as group
Quality
59.97
Promoting interoperability
100
Improvement activities
40
Cost
80.93

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53556TNMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Medical Group, Inc. CurrentSince Jun 1, 2022 Accepting new patients
Ut Regional One Physicians Inc CurrentSince May 1, 2016 Accepting new patients
Ut Regional One Physicians Inc CurrentSince May 1, 2016 Accepting new patients
Ut Medical Group Inc Psychiatry CurrentSince Jun 1, 2022 Accepting new patients

Locations

1068 Cresthaven Rd
Ste 300
Memphis, TN 38119
Phone (901) 683-0024

877 Jefferson Ave
Memphis, TN 38103
Phone (901) 448-5893

930 Madison Ave
Ste 200
Memphis, TN 38103
Phone (901) 448-6650

1068 Cresthaven Rd
Ste 500
Memphis, TN 38119
Phone (901) 476-2727

1068 Cresthaven Rd
Memphis, TN 38119
Phone (901) 683-0024

6215 Humphreys Blvd
Ste 201
Memphis, TN 38120
Phone (901) 866-8085

1407 Union Ave
Ste 700
Memphis, TN 38104
Phone (901) 866-8360

Organizations & group practices 4

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": "1282348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740528000000",
    "number": "1801102330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1068 CRESTHAVEN RD STE 300",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381190809",
            "telephone_number": "901-866-8864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1068 CRESTHAVEN RD STE 500",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381190846",
            "telephone_number": "901-448-2400",
            "fax_number": "901-302-2420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTHARI",
        "first_name": "KHYATI",
        "middle_name": "NIRMIT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-21",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TN",
            "license": "53556",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008452266",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "213682001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q021386",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.