Individual provider Active NPI

Michael A Rawdon, FNP MSN

  • Family Nurse Practitioner
  • Monterey, TN
National Provider Identifier
1013904184
Registry record updated Jul 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
7888 Issued in TN
Practice address
400 W Crawford Ave
Monterey, TN 38574-1166
Phone
(931) 839-2224
Fax
(931) 839-2530
NPI assigned
Oct 4, 2005
Last updated
Jul 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 7888 TN Primary

Addresses

Primary practice location

400 W Crawford Ave
Monterey, TN 38574-1166

Mailing address

400 W Crawford Ave
Monterey, TN 38574-1166
Phone (931) 839-2224

Other identifiers 3

IdentifierTypeStateIssuer
3903854MedicaidTN
4267523OtherTNBCBS
7100155710MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100823000794 TN Practitioner - Nurse Practitioner 9739213018 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Vanderbilt University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cookeville Regional Medical Group IncGroup PAC ID 8325092638, 54 clinicians

Practice addresses (Care Compare)

438 N Whitney Ave
Cookeville, TN 38501-2455
Phone (931) 783-2616

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
40.99 of 100Reported as group
Quality
58.34
Promoting interoperability
0
Improvement activities
0
Cost
78.29

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
7888TNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Monterey Medical LLC CurrentSince Jul 1, 2021 Accepting new patients

Locations

400 W Crawford Ave
Monterey, TN 38574
Phone (931) 839-2224

400 W Crawford Ave
Ste C
Monterey, TN 38574
Phone (931) 839-2224

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10383/brand/1/csg/1/fhir/r4
  • Direct secure messaging: michael.rawdon.1@10383.direct.athenahealth.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625702400000",
    "number": "1013904184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W CRAWFORD AVE",
            "city": "MONTEREY",
            "state": "TN",
            "postal_code": "385741166",
            "telephone_number": "931-839-2224",
            "fax_number": "931-839-2530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W CRAWFORD AVE",
            "city": "MONTEREY",
            "state": "TN",
            "postal_code": "385741166",
            "telephone_number": "931-839-2224",
            "fax_number": "931-839-2530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAWDON",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "credential": "FNP MSN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "7888",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3903854",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4267523",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100155710",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monterey, TN

Sources for this page

Verify at the official NPI Registry.