Kodihalli P Channabasappa, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

010618 Issued in TN

Practice address

607 W Due West Ave
Suite 122
Madison, TN 37115-4431

Phone

(615) 865-6111

NPI assigned

Sep 22, 2006

Last updated

Jan 18, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

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

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.

• Madison Adult Medicine, Inc.

  • Primary Care Clinic/Center
  • Madison, TN
  • NPI 1710085915
  NPD (past)

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200614400000",
    "number": "1982704870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 W DUE WEST AVE",
            "address_2": "SUITE 122",
            "city": "MADISON",
            "state": "TN",
            "postal_code": "371154431",
            "telephone_number": "615-865-6111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 W DUE WEST AVE",
            "address_2": "SUITE 122",
            "city": "MADISON",
            "state": "TN",
            "postal_code": "371154431",
            "telephone_number": "615-865-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANNABASAPPA",
        "first_name": "KODIHALLI",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2008-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TN",
            "license": "010618",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3163326",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Centerstone of Tennessee
• Centerstone Pharmacy
• Centerwell Senior Primary Care TN PC (CenterWell Senior Primary Care-Madison)
• Joaquin Joseph Quidachay Chaco Jr., RN
• Mary K Chandler
• Shai Charlton
• Paige Chenoweth
• L'Oreal M Cherry, M.S.
• Choice Family Healthcare PLLC
• Talisa Monae Christian

• Cardiovascular Disease Physician in Madison, TN
• Providers in Madison, TN by specialty
• Cardiovascular Disease Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 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.