Izzabella Marie Pogreba
Individual provider Active NPI Medical Physician Assistant · Tennessee Ridge, TN
NPI 1063363166 · NPPES record last updated Feb 4, 2026
Key facts
- NPI
- 1063363166
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- Practice address
- 540 Cook Hollow LN
Tennessee Ridge, TN 37178-5533 - Phone
- (931) 348-9099
- NPI assigned
- Feb 4, 2026
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | Yes |
Addresses
Primary practice location
540 Cook Hollow LN
Tennessee Ridge, TN 37178-5533
Mailing address
540 Cook Hollow LN
Tennessee Ridge, TN 37178-5533
Phone (931) 348-9099
Other providers in Tennessee Ridge, TN
- Anthony Lima Scott Leininger
- Terri Lynn McMillan
- Robert Mullikin
- Martha Jeanette Murray
- Rachel Lillian Myers
- Macha J Ross
- Bethany Joy Rougemont
- Barbara E Scott
- Torrey Seay
- Amanda Dawn Self
All providers in Tennessee Ridge, TN · Medical Physician Assistant in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 4, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.