DR. KODIHALLI P CHANNABASAPPA (NPI# 1982704870) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982704870 |
| Entity Type | Individual |
| Full Name | DR. KODIHALLI P CHANNABASAPPA |
| Credential | MD |
| Practice Address |
607 W Due West Ave Suite 122 Madison TN 37115-4431 |
| Practice Telephone | 6158656111 |
| Mailing Telephone | 6158656111 |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2008-01-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
010618 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 3163326 | 05 |
| Street Address |
607 W DUE WEST AVE SUITE 122 |
| City | MADISON |
| State | TN |
| Zip Code | 37115-4431 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912977430 | Marcus Min | Internal Medicine | 607 W Due West Ave, Suite 122, Madison, TN 37115-4431 | 2006-01-26 |
| 1588120695 | Embrace Health and Wellness | Clinic/Center | 607 W Due West Ave, Madison, TN 37115-4431 | 2019-02-13 |
| 1942709217 | Jenna Mayfield Morton | Physician Assistant | 607 W Due West Ave, Madison, TN 37115-4431 | 2018-02-01 |
| 1295273043 | Malones Group LLC | Clinical Nurse Specialist | 607 W Due West Ave, Suite 105, Madison, TN 37115-4431 | 2017-02-01 |
| 1902262298 | Orlando Lamar Jones | Nurse Practitioner | 607 W Due West Ave, Madison, TN 37115-4431 | 2016-01-04 |
| 1821429531 | Jackson Family Dental,pllc | Dentist | 607 W Due West Ave, Suit 110, Madison, TN 37115-4431 | 2013-12-05 |
| 1770830804 | Genesis Health and Wellness Group | Clinic/Center | 607 W Due West Ave, Suite 105, Madison, TN 37115-4431 | 2012-08-08 |
| 1851672299 | Carolyn Denise Jackson | Nurse Practitioner | 607 W Due West Ave, Madison, TN 37115-4431 | 2011-08-30 |
| 1750516449 | Choice Family Healthcare Pllc | Physician Assistant | 607 W Due West Ave, Suite # 105, Madison, TN 37115-4431 | 2009-05-25 |
| 1346483104 | Advanced Sleep Diagnostics, Inc. | Clinic/Center | 607 W Due West Ave, Madison, TN 37115-4431 | 2009-04-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023675212 | Kennedy Wayne Germany Jr. | Specialist/Technologist | 813 Seashell Cove, Madison, TN 37115 | 2019-05-22 |
| 1497211387 | Latasha Monique Williams | Social Worker | Patriot Place (va), 314 Williams Avenue, Ste. 100, Madison, TN 37115 | 2019-02-15 |
| 1659866481 | Amanda Elliott | Pharmacist | 109 Gallatin Rd, Madison, TN 37115 | 2018-06-25 |
| 1760938492 | Larry Cox | Case Manager/Care Coordinator | 620 S. Gallatin Pike, Madison, TN 37115 | 2016-09-01 |
| 1407202799 | National Vision, Inc. | Technician/Technologist | 1785 Gallatin Pike N, Madison, TN 37115 | 2016-05-05 |
| 1992190193 | Emily Tibbs | Case Manager/Care Coordinator | 620 Gallatin Pike, Madison, TN 37115 | 2015-04-03 |
| 1164829982 | Laura Boswell | Case Manager/Care Coordinator | 620 Gallatin Pike South, Madison, TN 37115 | 2014-11-21 |
| 1720498058 | Edward Andrew Roberts | Chiropractor | 1710 Gallatin Pike N, Madison, TN 37115 | 2014-05-08 |
| 1700296217 | Lamonia Merritt | Student in an Organized Health Care Education/Training Program | 645 Cheyenne Blvd, Madison, TN 37115 | 2014-05-06 |
| 1629497656 | Corey Joseph Cloud | Dentist | 500 Lentz Dr Ste 40, Madison, TN 37115 | 2014-04-07 |
| Find all providers in zip 37115 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://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 |
|---|---|---|---|---|
| 1215414727 | Telemedico Physicians of Wisconsin Sc | Internal Medicine | 301 S Bedford St Ste 1, Madison, WI 53703-3691 | 2018-07-26 |
| 1932489291 | Proactive Cardiology LLC | Internal Medicine | 2614 Hubbard Rd, Madison, OH 44057-2530 | 2011-08-18 |
| 1265730865 | Richard Glenn Hutchinson | Internal Medicine | 337 Long Cove Dr, Madison, MS 39110-9113 | 2011-03-05 |
| 1073844932 | James Harry Thomsen | Internal Medicine | 7709 Twinflower Dr, Madison, WI 53719-4544 | 2010-01-15 |
| 1194998955 | Manoochehr Meshginpoosh | Internal Medicine | 5856 Chapel Rd, Madison, OH 44057-1754 | 2008-04-11 |
| 1083893606 | Kornelia Keszler, Md, PC | Internal Medicine | 1-b Meigswood Ave, Madison, CT 06443 | 2007-10-31 |
| 1821002833 | Alfred E Hutcheson | Internal Medicine | 794 Highway 51, Suite D, Madison, MS 39110-9662 | 2006-07-27 |
| 1396701553 | Zilin Wang | Internal Medicine | 100 Whisper Lake Blvd, Madison, MS 39110-7881 | 2006-04-25 |
| 1396713368 | Bonnie Lynn Hiatt | Internal Medicine | 27 Indigo Trl, Madison, CT 06443-1960 | 2006-03-08 |
| 1861469470 | Tamara S Hagen | Internal Medicine | 811 Potawatomi Dr, Madison, WI 53718 | 2006-03-02 |
| Find all providers in MADISON | ||||
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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.