Individual provider Active NPI

Fathi Idris Ali, M.D.

  • Cardiovascular Disease Physician
  • Columbia, TN
National Provider Identifier
1811905409
Registry record updated Jan 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
44108 Issued in TN
Practice address
1220 Trotwood Ave
Suite 401
Columbia, TN 38401-6433
Phone
(931) 388-8622
Fax
(931) 381-7270
NPI assigned
Aug 3, 2006
Last updated
Jan 7, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 44108 TN Primary
Clinical Cardiac Electrophysiology Physician 207RC0001X 44108 TN
Interventional Cardiology Physician 207RI0011X 44108 TN

Addresses

Primary practice location

1220 Trotwood Ave
Suite 401
Columbia, TN 38401-6433

Mailing address

854 W James Campbell Blvd
Suite 303 a
Columbia, TN 38401-4659
Phone (931) 540-4255

Other identifiers 4

IdentifierTypeStateIssuer
4204226OtherTNBCBST
1509829MedicaidTN
3379860MedicaidTN
06CBBCGOtherGAMEDICARE #

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address FATHI.ALI@hca1.eclinicaldirectplus.com

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
I20081119000820 TN Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Cardiac Electrophysiology 5890794739 Reassigns benefits to 1 organization
Practice locations: Columbia, TN

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Cardiac Electrophysiology
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Centennial Heart LLCGroup PAC ID 9931204237, 121 clinicians

Practice addresses (Care Compare)

6716 Nolensville Rd
Suite 230
Brentwood, TN 37027-8864
Phone (615) 620-8020

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.26 of 100Reported as individual
Quality
87.04
Promoting interoperability
99
Improvement activities
40
Cost
87.05

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10
Pacemaker insertion or repair13

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Centennial Heart LLC Cardiovascular Disease CurrentSince Apr 17, 2018 Accepting new patients
Centennial Neuroscience, LLC Past Accepting new patients
Gainesville Heart and Vascular Group PC Past Accepting new patients

Locations

1001 Health Park Dr
Ste 509
Brentwood, TN 37027
Phone (615) 342-6840

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

6716 Nolensville Rd
Ste 230
Brentwood, TN 37027
Phone (615) 620-8020

2400 Patterson St
Ste 103
Nashville, TN 37203
Phone (615) 329-0929

397 Wallace Rd
Ste 414
Nashville, TN 37211
Phone (615) 333-0851

Interoperability endpoints

  • Direct secure messaging: fathi.ali@hca1.eclinicaldirectplus.com
  • FHIR API: https://api.platform.athenahealth.com/7421/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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.

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.

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641513600000",
    "number": "1811905409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "854 W JAMES CAMPBELL BLVD",
            "address_2": "SUITE 303 A",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384014659",
            "telephone_number": "931-540-4255",
            "fax_number": "931-540-4218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 TROTWOOD AVE",
            "address_2": "SUITE 401",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384016433",
            "telephone_number": "931-388-8622",
            "fax_number": "931-381-7270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALI",
        "first_name": "FATHI",
        "middle_name": "IDRIS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2022-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TN",
            "license": "44108",
            "primary": true
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "TN",
            "license": "44108",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "TN",
            "license": "44108",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBST",
            "identifier": "4204226",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1509829",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3379860",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE #",
            "identifier": "06CBBCG",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "FATHI.ALI@hca1.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "1220 Trotwood Ave",
            "address_2": "SUITE 401",
            "city": "Columbia",
            "state": "TN",
            "country_code": "US",
            "postal_code": "384016433",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbia, TN

Sources for this page

Verify at the official NPI Registry.