NPIMap

Individual provider Active NPI

Modupe Olusegun Kehinde, M.D.

  • Pulmonary Disease Physician
  • Lebanon, TN
National Provider Identifier
1912989989
Registry record updated Feb 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
40614 Issued in TN
Practice address
1424 Baddour Pkwy
Suite H
Lebanon, TN 37087
Phone
(615) 444-8686
NPI assigned
Nov 16, 2005
Last updated
Feb 18, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 40614 TN
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 40614 TN
Pulmonary Disease Physician 207RP1001X 40614 TN Primary

Addresses

Primary practice location

1424 Baddour Pkwy
Suite H
Lebanon, TN 37087

Mailing address

1424 Baddour Pkwy
Suite H
Lebanon, TN 37087
Phone (615) 444-8686

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060814000575 TN Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 8224011333 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1424 W Baddour Pkwy
Suite H
Lebanon, TN 37087-2685
Phone (615) 444-8686

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.5 of 100Reported as individual
Quality
88.61
Promoting interoperability
94
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Pulmonary and Critical Care Associates, PLLC Critical Care Medicine CurrentSince Jul 13, 2006 Accepting new patients

Locations

1424 W Baddour Pkwy
Ste H
Lebanon, TN 37087
Phone (615) 444-8686

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IFACAA
  • FHIR API: https://fhir4.healow.com/fhir/r4/IFACAA/Endpoint/IFACAA

Organizations & group practices 1

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": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581984000000",
    "number": "1912989989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1424 BADDOUR PKWY",
            "address_2": "SUITE H",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "37087",
            "telephone_number": "615-444-8686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1424 BADDOUR PKWY",
            "address_2": "SUITE H",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "37087",
            "telephone_number": "615-444-8686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEHINDE",
        "first_name": "MODUPE",
        "middle_name": "OLUSEGUN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-16",
        "last_updated": "2020-02-18",
        "certification_date": "2020-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "40614",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "TN",
            "license": "40614",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "TN",
            "license": "40614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, TN

Sources for this page

Verify at the official NPI Registry.