| Neurology Diagnostics Group, Pllc | |
|
1451 Elm Hill Pike Ste 107 Nashville TN 37210-4551 | |
| (866) 374-7648 | |
| (262) 754-0897 |
| Full Name | Neurology Diagnostics Group, Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1451 Elm Hill Pike Ste 107, Nashville, Tennessee |
| Authorized Official Name and Position | Chris Blank (CONTRACTING AND CREDENTIALING MANAG) |
| Authorized Official Contact | 2628756575 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neurology Diagnostics Group, Pllc 626 W Moreland Blvd Waukesha WI 53188-2433 Ph: (866) 374-7648 | Neurology Diagnostics Group, Pllc 1451 Elm Hill Pike Ste 107 Nashville TN 37210-4551 Ph: (866) 374-7648 |
| NPI Number | 1760225296 |
|---|---|
| Provider Enumeration Date | 06/13/2024 |
| Last Update Date | 06/13/2024 |
| Certification Date | 06/13/2024 |
| Medicare PECOS PAC ID | 5092247106 |
|---|---|
| Medicare Enrollment ID | O20241015000162 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760225296 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Pradeep Modur |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1346248515 PECOS PAC ID: 4082777990 Enrollment ID: I20241014002287 |
| Provider Name | Janel S Schneider |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1720002694 PECOS PAC ID: 3072547082 Enrollment ID: I20241015000272 |
| Provider Name | John Joseph Millichap |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1225211600 PECOS PAC ID: 4688827009 Enrollment ID: I20241015000481 |
| Provider Name | Conrad C Nievera |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1346292018 PECOS PAC ID: 8325123318 Enrollment ID: I20241015000762 |
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