Organization Active NPI

Family Care of Middletennessee

  • Specialist
  • Smyrna, TN
National Provider Identifier
1992985055
Registry record updated Nov 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
31779 Issued in TN
Legal business name
FAMILY CARE OF MIDDLETENNESSEE
Practice address
713A President PL
Smyrna, TN 37167-5652
Phone
(615) 220-0056
Fax
(615) 220-0456
NPI assigned
Nov 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2007

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

Authorized official

Name
Jithander Katkuri, MDNPI 1114974979
Title
Owner
Phone
(615) 220-0056

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 31779 TN Primary

Addresses

Primary practice location

713A President PL
Smyrna, TN 37167-5652

Mailing address

713A President PL
Smyrna, TN 37167-5652
Phone (615) 220-0056

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051105000241 TN Part B Supplier - Clinic/Group Practice 6406874650 Receives reassigned benefits from 5 practitioners
Practice locations: Smyrna, TN

National Provider Directory

National Provider Directory

Locations

4928 Edmondson Pike
Ste 105
Nashville, TN 37211
Phone (615) 833-1622

713A President Pl
Smyrna, TN 37167
Phone (615) 220-0056

Interoperability endpoints

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

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1194307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194307200000",
    "number": "1992985055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713A PRESIDENT PL",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371675652",
            "telephone_number": "615-220-0056",
            "fax_number": "615-220-0456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713A PRESIDENT PL",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371675652",
            "telephone_number": "615-220-0056",
            "fax_number": "615-220-0456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY CARE OF MIDDLETENNESSEE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-06",
        "last_updated": "2007-11-06",
        "status": "A",
        "authorized_official_last_name": "KATKURI",
        "authorized_official_first_name": "JITHANDER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "615-220-0056",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "TN",
            "license": "31779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smyrna, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.