Active NPI
Patricia L. Verhulst, MD
- Diagnostic Radiology Physician
- Clarksville, TN
National Provider Identifier
1831293497
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 42702
- Practice address
- 2831 Wilma Rudolph Blvd
Clarksville, TN 37040-5002 - Phone
- (931) 245-8600
- Fax
- (931) 245-8660
- NPI assigned
- Sep 12, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 34111 | KY | |
| Diagnostic Radiology Physician | 2085R0202X | 42702 | TN | Primary |
Addresses
Primary practice location
2831 Wilma Rudolph Blvd
Clarksville, TN 37040-5002
Mailing address
PO Box 5000
Lebanon, TN 37088-5000
Phone (615) 444-2320
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000696946 | Other | KY | BCBS |
| 64341118 | Medicaid | KY | |
| 3000647 | Medicaid | TN | |
| P00915988 | Other | KY | RR MEDICARE |
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 |
|---|---|---|---|
| 42702 | TN | MD | Licensed Practical Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| X-Ray Associates | Diagnostic Radiology | Past | Accepting new patients |
| Bedford Radiology, PLLC | Diagnostic Radiology | Past | Accepting new patients |
| Radiology PSC | Diagnostic Radiology | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Diagnostic Radiology Physician
- Clarksville, TN
- NPI 1104860857
-
- Diagnostic Radiology Physician
- Owensboro, KY
- NPI 1700976743
-
- Diagnostic Radiology Physician
- Hartford, KY
- NPI 1043314693
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307491200000",
"number": "1831293497",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5000",
"city": "LEBANON",
"state": "TN",
"postal_code": "370885000",
"telephone_number": "615-444-2320",
"fax_number": "615-449-3163"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2831 WILMA RUDOLPH BLVD",
"city": "CLARKSVILLE",
"state": "TN",
"postal_code": "370405002",
"telephone_number": "931-245-8600",
"fax_number": "931-245-8660"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VERHULST",
"first_name": "PATRICIA",
"middle_name": "L.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-12",
"last_updated": "2011-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "KY",
"license": "34111",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "TN",
"license": "42702",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "000000696946",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64341118",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3000647",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00915988",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Clarksville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.