Organization Active NPI

Donelson Family Practice, PLLC

  • Family Medicine Physician
  • Nashville, TN
National Provider Identifier
1972754315
Registry record updated Oct 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M.D. 8780 Issued in TN
Legal business name
DONELSON FAMILY PRACTICE, PLLC
Practice address
205 Donelson Pike
Nashville, TN 37214-2903
Phone
(615) 885-3223
Fax
(615) 885-3231
NPI assigned
Oct 3, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2008

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

Authorized official

Name
Mr. Radnakanta Mishra, PH.D
Title
Office Manager
Phone
(615) 885-3223

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X M.D. 8780 TN Primary

Addresses

Primary practice location

205 Donelson Pike
Nashville, TN 37214-2903

Mailing address

205 Donelson Pike
Nashville, TN 37214-2903
Phone (615) 885-3223

Other identifiers 1

IdentifierTypeStateIssuer
3166992MedicaidTN

National Provider Directory

National Provider Directory

Locations

205 Donelson Pike
Nashville, TN 37214
Phone (615) 885-3223

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1222992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222992000000",
    "number": "1972754315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 DONELSON PIKE",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372142903",
            "telephone_number": "615-885-3223",
            "fax_number": "615-885-3231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 DONELSON PIKE",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372142903",
            "telephone_number": "615-885-3223",
            "fax_number": "615-885-3231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DONELSON FAMILY PRACTICE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-03",
        "last_updated": "2008-10-03",
        "status": "A",
        "authorized_official_last_name": "MISHRA",
        "authorized_official_first_name": "RADNAKANTA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "615-885-3223",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PH.D"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "M.D. 8780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3166992",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2008; 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.