Individual provider Active NPI

Ankit Kushwaha, MD

  • Pulmonary Disease Physician
  • Jackson, TN
National Provider Identifier
1932698339
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
69697 Issued in TN
Practice address
587 Skyline Dr
Jackson, TN 38301-3938
Phone
(731) 422-7900
Fax
(731) 599-4246
NPI assigned
May 2, 2018
Last updated
Jun 20, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 69697 TN
Pulmonary Disease Physician 207RP1001X 69697 TN Primary

Addresses

Primary practice location

587 Skyline Dr
Jackson, TN 38301-3938

Mailing address

587 Skyline Dr
Jackson, TN 38301-3938
Phone (731) 422-7900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240508002260 TN Practitioner - Pulmonary Disease 4183065105 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Tennessee Healthcare Hospitalists IncGroup PAC ID 1951735521, 98 clinicians
West Tennessee Medical Group IncGroup PAC ID 3971781006, 190 clinicians

Practice addresses (Care Compare)

620 Skyline Dr
Jackson, TN 38301-3923
Phone (731) 541-4923

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
69697TNMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Tennessee Medical Group Inc CurrentSince Jul 1, 2024 Accepting new patients
West Tennessee Healthcare Hospitalists Inc CurrentSince May 1, 2024 Accepting new patients
Jackson Surgical Associates. PA Past Accepting new patients

Locations

257 Bancorp South Pkwy
Jackson, TN 38305
Phone (731) 512-1283

587 Skyline Dr
Jackson, TN 38301
Phone (731) 421-6510

620 Skyline Dr
Jackson, TN 38301
Phone (731) 541-4923

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, 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": "1525219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1932698339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "587 SKYLINE DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013938",
            "telephone_number": "731-422-7900",
            "fax_number": "731-599-4246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "587 SKYLINE DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013938",
            "telephone_number": "731-422-7900",
            "fax_number": "731-599-4246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUSHWAHA",
        "first_name": "ANKIT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-02",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "TN",
            "license": "69697",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "TN",
            "license": "69697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.