Active NPI
Robert W. Wahl, M.D.
- Anatomic Pathology & Clinical Pathology Physician
- Brentwood, TN
National Provider Identifier
1831281963
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 9536
- Practice address
- 5301 Virginia Way
Ste 300
Brentwood, TN 37027-7541 - Phone
- (615) 221-4474
- Fax
- (615) 234-3774
- NPI assigned
- Sep 28, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 9536 | TN | Primary |
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 18591 | KY |
Addresses
Primary practice location
5301 Virginia Way
Ste 300
Brentwood, TN 37027-7541
Mailing address
5301 Virginia Way
Ste 300
Brentwood, TN 37027-7541
Phone (615) 221-4474
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 119361 | Other | TN | UNISON TENNCARE |
| 0053759 | Other | TN | BLUE CROSS |
| 64777030 | Medicaid | KY | |
| 1218779 | Medicaid | OH | |
| 3041804 | Medicaid | TN | |
| 89063HH | Medicaid | NC | |
| 000000001589 | Other | TN | TLC TENNCARE |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18591 | KY | MD | Anatomic Pathology & Clinical Pathology Physician |
| 9536 | TN | MD | Anatomic Pathology & Clinical Pathology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Associated Pathologists, LLC | Anatomic Pathology & Clinical Pathology | Current | Accepting new patients |
| Associated Pathologists LLC | Past | Accepting new patients |
Locations
5301 Virginia Way
Ste 300
Brentwood, TN 37027
Phone (615) 695-4977
1010 Airpark Center Dr
Nashville, TN 37217
Phone (615) 221-4447
658 Grassmere Park
Nashville, TN 37211
Phone (866) 941-8398
Organizations & group practices 2
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.
-
- Anatomic Pathology & Clinical Pathology Physician
- Nashville, TN
- NPI 1003863580
-
- Clinical Medical Laboratory
- Nashville, TN
- NPI 1124075635
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1831281963",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5301 VIRGINIA WAY",
"address_2": "STE 300",
"city": "BRENTWOOD",
"state": "TN",
"postal_code": "370277541",
"telephone_number": "615-221-4474",
"fax_number": "615-234-3774"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5301 VIRGINIA WAY",
"address_2": "STE 300",
"city": "BRENTWOOD",
"state": "TN",
"postal_code": "370277541",
"telephone_number": "615-221-4474",
"fax_number": "615-234-3774"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAHL",
"first_name": "ROBERT",
"middle_name": "W.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "TN",
"license": "9536",
"primary": true
},
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "KY",
"license": "18591",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNISON TENNCARE",
"identifier": "119361",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "0053759",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64777030",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1218779",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3041804",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "89063HH",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TLC TENNCARE",
"identifier": "000000001589",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Brentwood, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.