DR. VIJAY PETHKAR MD PLLC (NPI# 1356474415) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356474415 |
| Entity Type | Organization |
| Organization Name | DR. VIJAY PETHKAR MD PLLC |
| Other Organization Name | VIJAY PETHKAR MD PLLC |
| Practice Address |
780 N Mount Juliet Rd Mount Juliet TN 37122-3323 |
| Practice Telephone | 6157589273 |
| Practice Fax Number | 6157584821 |
| Mailing Telephone | 6157589273 |
| Mailing Fax Number | 6157584821 |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2011-09-07 |
| Authorized Official Name | VIJAY PETHKAR (OWNER) |
| Authorized Official Telephone | 6157589273 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RS0012X |
Internal Medicine Specialization: Sleep Medicine |
MD31687 | Allopathic & Osteopathic Physicians | |
| N | 261QS1200X |
Clinic/Center Specialization: Sleep Disorder Diagnostic |
MD31687 | TN | Ambulatory Health Care Facilities |
| Y | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
MD31687 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 3729715 | 05 |
| Other Name | Type Code |
|---|---|
| Vijay Pethkar MD PLLC | Other Name - Individual/Organization |
| Street Address |
780 N MOUNT JULIET RD |
| City | MOUNT JULIET |
| State | TN |
| Zip Code | 37122-3323 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720628084 | Your Motion Physical Therapy Pllc | Physical Therapist | 102 Vanner Rd, Mt. Juliet, TN 37122 | 2020-01-14 |
| 1639728355 | Brantley Allen Thigpen | Student in an Organized Health Care Education/Training Program | 2128, Fellowshid Rd, Mount Juliet, TN 37122 | 2019-09-05 |
| 1811479272 | Jessica Danielle Parker | Nurse Practitioner | 854 N Mt Juliet Road, Mt Juliet, TN 37122 | 2018-09-02 |
| 1952891798 | Twin Lakes Dental Care Pllc | Clinic/Center | 11315 Lebanon Rd, Mount Juliet, TN 37122 | 2018-05-17 |
| 1346768983 | William Siegel | Chiropractor | 650 S. Mount Juliet Rd. Suite 105, Mount Juliet, TN 37122 | 2017-09-04 |
| 1194269506 | Michele Mcdermitt | Nurse Practitioner | 108 Providence Trail, Mt. Juliet, TN 37122 | 2016-12-05 |
| 1720537491 | Mt. Juliet Dental Group, PC | Dentist | 4155 N Mt Juliet Rd, Mt. Juliet, TN 37122 | 2016-09-23 |
| 1407302169 | Comprehensive Neurology Center, Pllc | Psychiatry & Neurology | 5000 Crossings Cir Ste 101, Mt Juliet, TN 37122 | 2016-08-31 |
| 1639624109 | Samantha Nicole Grishaber | Occupational Therapist | 5000 Crossing Circle, Suite 100, Mount Juliet, TN 37122 | 2016-08-24 |
| 1033584461 | Kimberly Campbell | Nurse Practitioner | 3500 N Mount Juliet Rd Ste 201, Mt Juliet, TN 37122 | 2015-12-10 |
| Find all providers in zip 37122 | ||||
| Taxonomy Code | 207RP1001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Pulmonary Disease |
| An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962035774 | East Tennessee Pulmonary and Sleep Medicine | Internal Medicine | 1404 Tusculum Blvd Ste 2200, Greeneville, TN 37745-4395 | 2020-02-20 |
| 1043722754 | Nathan H Mull Iv LLC | Internal Medicine | 200 Sylvan Dr, Lookout Mountain, TN 37350-1630 | 2017-11-03 |
| 1639694615 | Eventa LLC | Internal Medicine | 102 W Court Sq, Livingston, TN 38570-1882 | 2017-08-10 |
| 1669903803 | Blue Ridge Medical Management Corporation | Internal Medicine | 1497 W Elk Ave Ste 22b, Elizabethton, TN 37643-2896 | 2017-03-21 |
| 1437502960 | Hawkins Physician Services,pllc | Internal Medicine | 1112 E Main St, Rogersville, TN 37857-2808 | 2016-07-20 |
| 1063830826 | Rachel Guthrie | Internal Medicine | 1900 N Winston Rd Ste 501, Knoxville, TN 37919-3605 | 2014-03-30 |
| 1326312091 | Theodore Feld Reiss | Internal Medicine | 1161 21st Ave South T-1218 Medical Center North, Vanderbilt University School of Medicine, Nashville, TN 37232-2650 | 2012-02-28 |
| 1699065722 | Radhika Shah | Internal Medicine | 979 E 3rd St Ste C735, Chattanooga, TN 37403-3310 | 2011-04-11 |
| 1902103666 | Amanda Kay Vanlandingham | Internal Medicine | 310 N State of Franklin Rd Ste 303, Johnson City, TN 37604-6051 | 2011-02-16 |
| 1528360765 | Geraldo Enrique Holguin | Internal Medicine | 725 Glenwood Dr Ste E500, Chattanooga, TN 37404-1138 | 2010-11-20 |
| Find all providers with the same taxonomy | ||||
| City | MOUNT JULIET |
| Zip Code | 37122 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.