NPIMap

Individual provider Active NPI

Ruhul Ahmed Choudhury, MD

  • Internal Medicine Physician
  • Williamsburg, KY
National Provider Identifier
1871531889
Registry record updated Mar 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
34311 Issued in KY
Practice address
3080 N Highway 25 W
Williamsburg, KY 40769-8602
Phone
(606) 549-9107
Fax
(606) 549-9862
NPI assigned
Jun 2, 2006
Last updated
Mar 13, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 30920 TN
Internal Medicine Physician 207R00000X 30920 TN
Internal Medicine Physician 207R00000X 34311 KY Primary

Addresses

Primary practice location

3080 N Highway 25 W
Williamsburg, KY 40769-8602

Mailing address

292 N Main St
Jellico, TN 37762-2132
Phone (423) 784-3600

Other identifiers 9

IdentifierTypeStateIssuer
100021020MedicaidTN
KY0109OtherTNJOHN DEERE
3832392MedicaidTN
64353113MedicaidKY
4102759OtherTNBCBS OF TN
3116107OtherTNBCBST
3116107MedicaidTN
110179309OtherMEDICARE RAILROAD
P00234830OtherTNRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, KY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050816000754 TN Practitioner - Internal MedicinePractitioner - Emergency Medicine 2769412113 Reassigns benefits to 2 organizations
I20120208000686 KY Practitioner - Internal Medicine 2769412113 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Hospital, Inc.Group PAC ID 4486616141, 60 clinicians

Practice addresses (Care Compare)

56 Marie Langdon Dr
Manchester, KY 40962-6329
Phone (606) 599-4080

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34311KYMDInternal Medicine Physician
30920TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital Inc. Internal Medicine CurrentSince May 18, 2025 Accepting new patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Jan 24, 2014 Accepting new patients
Memorial Hospital, Inc. Emergency Medicine Current Accepting new patients
Memorial Hospital, Inc. CurrentSince May 18, 2025 Accepting new patients
Appalachia Health Services LLC Current Accepting new patients
Emergency Coverage Services, PC Past Accepting new patients
Jellico Emergency Physicians Medical Group PC Emergency Medicine Past Accepting new patients
Pine Mountain Emergency Physicians Emergency Medicine Past Accepting new patients
Emergency Coverage, LLC Emergency Medicine Past Accepting new patients
Jellico Community Hospital Inc. Past Accepting new patients
Jellico TN Opco LLC Past Accepting new patients

Locations

210 Marie Langdon Dr
Manchester, KY 40962
Phone (865) 985-7047

188 Hospital Ln
Jellico, TN 37762
Phone (423) 784-1272

188 Hospital Ln
Ste 1
Jellico, TN 37762
Phone (423) 784-1197

292 N Main St
Jellico, TN 37762
Phone (423) 784-2020

9352 Park West Blvd
Knoxville, TN 37923
Phone (865) 373-1000

Interoperability endpoints

  • Direct secure messaging: ruhul.choudhury.1@11790.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Beech Tree Post Acute and Rehabilitation CenterJellico, TN, CCN 445292 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2022
Jan 1, 2022
Appalachia Health Services LLCJellico, TN, CCN 443931 Rural health clinic 5% Or Greater Direct Ownership Interest
Corporate Director		 Jan 1, 2002
Nov 1, 2008
Appalachia Health Services LLCWilliamsburg, KY, CCN 183893 Rural health clinic 5% Or Greater Direct Ownership Interest (50%)
Corporate Director		 Nov 1, 2008
Nov 1, 2008

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 12

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 2

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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426204800000",
    "number": "1871531889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "292 N MAIN ST",
            "city": "JELLICO",
            "state": "TN",
            "postal_code": "377622132",
            "telephone_number": "423-784-3600",
            "fax_number": "423-784-4602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3080 N HIGHWAY 25 W",
            "city": "WILLIAMSBURG",
            "state": "KY",
            "postal_code": "407698602",
            "telephone_number": "606-549-9107",
            "fax_number": "606-549-9862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOUDHURY",
        "first_name": "RUHUL",
        "middle_name": "AHMED",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2015-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "30920",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "30920",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "34311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100021020",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE",
            "identifier": "KY0109",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3832392",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64353113",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TN",
            "identifier": "4102759",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBST",
            "identifier": "3116107",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3116107",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "110179309",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00234830",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsburg, KY

Sources for this page

Verify at the official NPI Registry.