Gastrointestinal Specialists of Clarksville, PC

Primary specialty

Endoscopy Clinic/CenterTaxonomy code 261QE0800X

License

0000000112 Issued in TN

Legal business name

GASTROINTESTINAL SPECIALISTS OF CLARKSVILLE, PC

Doing business as

Gi Specialists of Clarksville, PC

Practice address

280 Warfield Blvd
Clarksville, TN 37043-1828

Phone

(931) 551-9605

Fax

(931) 503-0386

NPI assigned

Aug 19, 2006

Last updated

Jan 26, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Divya Anil Patel

Title

Office Manager

Phone

(931) 551-9605

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Gi Specialists of Clarksville, PC Doing business as

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Listed as

Gastrointestinal Specialists of Clarksville PCCCN 44C0001105

Medicare certification status

ActiveFrom the Provider of Services file

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327536000000",
    "number": "1982718524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 WARFIELD BLVD",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370431828",
            "telephone_number": "931-551-9605",
            "fax_number": "931-503-0386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 WARFIELD BLVD",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370431828",
            "telephone_number": "931-551-9605",
            "fax_number": "931-503-0386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GASTROINTESTINAL SPECIALISTS OF CLARKSVILLE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2012-01-26",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "DIVYA",
        "authorized_official_middle_name": "ANIL",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "931-551-9605",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QE0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Endoscopy",
            "state": "TN",
            "license": "0000000112",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3721795",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gi Specialists of Clarksville, PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Endoscopy Clinic/Center in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Endoscopy Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.