Individual provider Active NPI

Patricia L. Verhulst, MD

  • Diagnostic Radiology Physician
  • Clarksville, TN
National Provider Identifier
1831293497
Registry record updated Jun 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
42702 Issued in TN
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

Updated by the provider on Jun 8, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
000000696946OtherKYBCBS
64341118MedicaidKY
3000647MedicaidTN
P00915988OtherKYRR 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

LicenseStateTypeSpecialty
42702TNMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.