YN PAKKALA M.D, P.C
NPI 1841555141
General Practice in Bolivar, TN

Q: What is Yn Pakkala M.D, P.C's NPI number?

The NPI number for Yn Pakkala M.D, P.C is 1841555141. It was assigned to this organization in the NPPES registry on July 12, 2012.

Q: What is Yn Pakkala M.D, P.C's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Active since July 12, 2012CLIA 44D0694276 · Waiver

630 NUCKOLLS RD, BOLIVAR, TN 38008(731) 658-6011(731) 658-9884 Get Directions Write a Review

NPPES record last updated: September 9, 2013. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Yn Pakkala M.d, P.c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

YN PAKKALA M.D, P.C (NPI 1841555141) is a healthcare organization registered as a general practice in Bolivar, Tennessee and active in the NPI registry since July 2012. The organization holds a CLIA Waiver certificate valid through July 8, 2028 and lists Nithyananda Pakkala, Doctor, as its authorized official.

NPPES Registry Identity

NPI1841555141

Entity TypeOrganization

Primary Taxonomy208D00000X

Legal Business NameYN PAKKALA M.D, P.C

Location Address630 NUCKOLLS RDBolivar, TN 38008-1532

Mailing Address630 Nuckolls RdBolivar, TN 38008-1532 · (731) 658-6011 · Fax (731) 658-9884

Phone(731) 658-6011

Fax(731) 658-9884

Organization SubpartNo

Authorized OfficialNithyananda PakkalaDoctor · (731) 658-6011

Enumeration DateJuly 12, 2012

Last NPPES UpdateSeptember 9, 2013

✔ NPI 1841555141 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians

Taxonomy Code208D00000X

License✔ Licensed in TN · MD9916

Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

630 NUCKOLLS RD, Bolivar, TN 38008

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Yn Pakkala M.d, P.c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Yn Pakkala M.D, P.C, which bills Medicare for the services this clinician delivers.

Clinician (1)

Nithyananda Pakkala, M.D.

Family Practice

NPI 1578558607

630 NUCKOLLS RD
Bolivar, TN 38008

(731) 658-6011

✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 44D0694276

Y N Pakkala MD PC · Bolivar, TN

Active · expires Jul 8, 2028

CLIA Number44D0694276

Laboratory TypePhysician Office

Certificate Effective DateJuly 9, 2026

Certificate Expiration DateJuly 8, 2028

Laboratory DirectorDr. Y N. Pakkala

Laboratory Phone(731) 658-6011

Laboratory LocationY N Pakkala MD PC630 Nuckolls Road, Bolivar, TN 38008

CLIA data matches this NPI record on: Address Phone

This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Yn Pakkala M.D, P.C's NPI number?

The NPI number for Yn Pakkala M.D, P.C is 1841555141. It was assigned to this organization in the NPPES registry on July 12, 2012.

Where is Yn Pakkala M.D, P.C located?

Yn Pakkala M.D, P.C is located at 630 Nuckolls Rd, Bolivar, TN 38008. The listed phone number is (731) 658-6011.

What is Yn Pakkala M.D, P.C's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Yn Pakkala M.D, P.C enrolled in Medicare?

Yes. Yn Pakkala M.D, P.C is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Yn Pakkala M.D, P.C?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Yn Pakkala M.D, P.C. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Yn Pakkala M.D, P.C hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 44D0694276) is associated with this NPI, valid through July 8, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Yn Pakkala M.D, P.C accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Yn Pakkala M.D, P.C as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Yn Pakkala M.D, P.C was last updated on September 9, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.