Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Nithyananda Pakkala, MD

Individual provider Family Medicine Physician · NPI 1578558607

Dr. Nithyananda Pakkala, MD is a Family Practice in Bolivar, Tennessee. Qualified in 1968, 58 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Tennessee.

Years since qualifying
58
Licensed in
TN
In the registry since
2005
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

630 Nuckolls Rd
Bolivar, TN 38008-1532
Phone: (731) 658-6011
Fax: (731) 658-9884
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence MD9916 (TN)
Surgery Physician Taxonomy 208600000X · Licence MD9916 (TN)

Record details

NPI number1578558607
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedSeptember 14, 2005
Last updated in NPPESDecember 30, 2009
Mailing address630 Nuckolls Rd, Bolivar, TN 38008-1532

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Also practisesGENERAL SURGERY
Medical schoolOTHER
Graduated 1968 (58 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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