Individual provider Active NPI

Christine Jeanette (J.) Deyholos, M.D.

  • Vascular Surgery Physician
  • Nashville, TN
National Provider Identifier
1992196463
Registry record updated Mar 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
61179 Issued in TN
Practice address
1161 21St Ave S
D-5237 Medical Center North
Nashville, TN 37232-0011
Phone
(615) 875-1743
NPI assigned
Feb 5, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X CT
Student in an Organized Health Care Education/Training Program 390200000X
Vascular Surgery Physician 2086S0129X 61179 TN Primary

Addresses

Primary practice location

1161 21St Ave S
D-5237 Medical Center North
Nashville, TN 37232-0011

Mailing address

3841 Green Hills Village Dr Ste 200
Nashville, TN 37215-2691
Phone (615) 875-1743

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cdeyholos574933@direct.vumc.org Direct

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
I20200903002487 TN Practitioner - General Surgery 8123331048 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Vanderbilt University Medical CenterGroup PAC ID 5092023416, 3,510 clinicians

Practice addresses (Care Compare)

1301 22ND Ave S
Nashville, TN 37232-5100
Phone (615) 322-3000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10
Varicose vein removal1-10
Leg revascularization (restoring blood flow)13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61179TNMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vanderbilt University Medical Center CurrentSince Aug 21, 2020 Accepting new patients
Vanderbilt University Past Accepting new patients
Vanderbilt University PastSince Aug 21, 2020 Accepting new patients

Locations

Dept A T 40379
Atlanta, GA 31192

3841 Green Hills Village Dr
Ste 200
Nashville, TN 37215
Phone (615) 322-6842

719 Thompson Ln
Nashville, TN 37204
Phone (615) 322-6485

2839 Highway 231 N
Ste 209
Shelbyville, TN 37160
Phone (931) 685-4492

Interoperability endpoints

  • Direct secure messaging: cdeyholos574933@direct.vumc.org

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1423094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648684800000",
    "number": "1992196463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3841 GREEN HILLS VILLAGE DR STE 200",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372152691",
            "telephone_number": "615-875-1743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1161 21ST AVE S",
            "address_2": "D-5237 MEDICAL CENTER NORTH",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372320011",
            "telephone_number": "615-875-1743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEYHOLOS",
        "first_name": "CHRISTINE",
        "middle_name": "JEANETTE (J.)",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-05",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "TN",
            "license": "61179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cdeyholos574933@direct.vumc.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Health Information Service Provider",
            "address_1": "1161 21st Ave S",
            "address_2": "D-5237 Medical Center North",
            "city": "Nashville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "372320011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

Verify at the official NPI Registry.