Louis A Modica, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

MD15612 Issued in TN

Practice address

Building #8 Dogwood Ave
Vamc
Mountain Home, TN 37684-6062

Phone

(423) 439-7201

Fax

(423) 439-7219

NPI assigned

Sep 16, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Medical Education Assistance Corporation

  dba ETSU Physicians and Associates

  • Internal Medicine Physician
  • Johnson City, TN
  • NPI 1235180480

  Surgery

  NPD (past)

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

{
    "created_epoch": "1126828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296691200000",
    "number": "1982699880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 699",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "376840699",
            "telephone_number": "423-433-6039",
            "fax_number": "423-433-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BUILDING #8 DOGWOOD AVE",
            "address_2": "VAMC",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "376846062",
            "telephone_number": "423-439-7201",
            "fax_number": "423-439-7219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODICA",
        "first_name": "LOUIS",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-16",
        "last_updated": "2011-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "MD15612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carolyn Diane Miller, P.T.
• Merry N Miller, M.D.
• Stacy Miller
• Angela Phillips Milligan, FNP-BC
• Jacob Alexander Mills
• Fernando Ray Montgomery
• Julianne Moore
• Norman C Moore, MD
• Michele R Moser, PH.D
• Amanda Gail Mosley, RRT

• Surgery Physician in Mountain Home, TN
• Providers in Mountain Home, TN by specialty
• Surgery Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.