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

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: August 02, 2026.

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
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

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

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.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Family Medicine
630 NUCKOLLS RD
BOLIVAR, TN 38008

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.

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 from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Magnolia Health, Ambetter of Alabama and Ambetter of North Carolina and 1 other insurer 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 12 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.