Individual provider Active NPI

John W Interlandi, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Hermitage, TN
National Provider Identifier
1992790174
Registry record updated May 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
12079 Issued in TN
Practice address
3901 Central Pike Ste 555
Hermitage, TN 37076
Phone
(615) 874-9667
Fax
(615) 871-9682
NPI assigned
Sep 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 12079 TN Primary

Addresses

Primary practice location

3901 Central Pike Ste 555
Hermitage, TN 37076

Mailing address

53 Century Blvd Ste 120
Nashville, TN 37214-3693
Phone (615) 346-6213

Other practice location 1

5651 Frist Blvd
Ste 415
Hermitage, TN 37076-2054
Phone (615) 871-7258

Other identifiers 3

IdentifierTypeStateIssuer
3186316MedicaidTN
6060183OtherTNBLUE CROSS BLUE SHIELD
Q019961MedicaidTN

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
I20060524000202 TN Practitioner - EndocrinologyPractitioner - Internal Medicine 2163433574 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Vanderbilt University School of Medicine, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Botts Diabetes and EndocrinologyGroup PAC ID 5496094062, 3 clinicians

Practice addresses (Care Compare)

1420 W Baddour Pkwy
Suite 200
Lebanon, TN 37087-1510
Phone (615) 444-4126

Hospital & facility affiliations

  • Tristar Summit Medical Center Hospital, Hermitage, TN, CCN 440150

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bradshaw Medical Clinic, PC Past Accepting new patients
Vanderbilt University PastSince Feb 24, 2020 Accepting new patients

Interoperability endpoints

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

Organizations & group practices 4

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 1

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": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557792000000",
    "number": "1992790174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 CENTURY BLVD STE 120",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372143693",
            "telephone_number": "615-346-6213",
            "fax_number": "615-346-6225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 CENTRAL PIKE STE 555",
            "city": "HERMITAGE",
            "state": "TN",
            "postal_code": "37076",
            "telephone_number": "615-874-9667",
            "fax_number": "615-871-9682"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5651 Frist Blvd",
            "address_2": "Ste 415",
            "address_purpose": "LOCATION",
            "city": "Hermitage",
            "state": "TN",
            "postal_code": "370762054",
            "country_code": "US",
            "telephone_number": "615-871-7258",
            "fax_number": "614-871-4982",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "INTERLANDI",
        "first_name": "JOHN",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-14",
        "last_updated": "2019-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "TN",
            "license": "12079",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3186316",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "6060183",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q019961",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hermitage, TN

Sources for this page

Verify at the official NPI Registry.