NPIMap

Individual provider Active NPI

Mohammad A Alsoub, MD

  • Pulmonary Disease Physician
  • Dickson, TN
National Provider Identifier
1063407534
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
38437 Issued in TN
Practice address
111 Highway 70 E Ste 102
Dickson, TN 37055-2080
Phone
(615) 375-1531
Fax
(615) 375-1526
NPI assigned
Sep 12, 2005
Last updated
Apr 16, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 38437 TN
Pulmonary Disease Physician 207RP1001X 38437 TN Primary

Addresses

Primary practice location

111 Highway 70 E Ste 102
Dickson, TN 37055-2080

Mailing address

127 Crestview Park Dr Ste 209
Dickson, TN 37055-2856
Phone (615) 446-5121

Other practice location 1

895 Powers Blvd
Waverly, TN 37185-1018
Phone (931) 296-7552

Other identifiers 6

IdentifierTypeStateIssuer
1516719MedicaidTN
3894698MedicaidTN
4138005OtherTNBLUE CROSS BLUE SHIELD TN
6060612OtherTNBCBS
P00359629OtherRAILROAD MEDICARE PIN
103I295563OtherTNMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040828000022 TN Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 9335114826 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dickson Medical Associates, PCGroup PAC ID 3971408774, 55 clinicians

Practice addresses (Care Compare)

111 Hwy 70 E
Suite 102
Dickson, TN 37055-2080
Phone (615) 375-1531

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mdsleep, Inc CurrentSince Aug 2, 2019 Accepting new patients
Diagnostic Testing Services, LLC CurrentSince Apr 1, 2024 Accepting new patients
Dickson Medical Associates PC CurrentSince Apr 1, 2021 Accepting new patients
Hospitalists at Horizon Medical Center LLC Past Accepting new patients
Waverly Health Care and Rehabilitation Center, LLC Past Accepting new patients
Pulmonary Medicine of Dickson, LLC Pulmonary Disease Past Accepting new patients

Locations

7155 Lee Hwy
Ste 400
Chattanooga, TN 37421
Phone (423) 499-2637

111 Highway 70 E
Ste 102
Dickson, TN 37055
Phone (615) 229-3045

127 Crestview Park Dr
Dickson, TN 37055
Phone (615) 441-4478

127 Crestview Park Dr
Ste 209
Dickson, TN 37055

Interoperability endpoints

  • Direct secure messaging: malsoub@direct.meditouchehr.com
  • Direct secure messaging: malsoub26921@dicksonmedicalassociates.gardenplot.direct-ci.com

Ownership & related parties

All facility ownership & control disclosures 7

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Dickson Medical Associates, PCWaverly, TN, CCN 448958 Rural health clinic General Partnership Interest (4.93%) Apr 1, 2022
Dma South PediatricsDickson, TN, CCN 883843 Rural health clinic 5% Or Greater Direct Ownership Interest (4.93%) Apr 1, 2022
Dickson Medical Associate White BluffWhite Bluff, TN, CCN 883842 Rural health clinic 5% Or Greater Direct Ownership Interest (4.93%) Apr 1, 2022
Dickson Medical Associates, PCFairview, TN, CCN 883917 Rural health clinic 5% Or Greater Direct Ownership Interest (4.93%) Apr 1, 2022
Dma Pediatrics and Specialty ClinicWaverly, TN, CCN 883924 Rural health clinic 5% Or Greater Direct Ownership Interest (4.93%) Apr 1, 2022
First Priority HealthHohenwald, TN, CCN 883955 Rural health clinic 5% Or Greater Direct Ownership Interest (4.93%) Apr 1, 2022
Dma SouthDickson, TN, CCN 888923 Rural health clinic 5% Or Greater Direct Ownership Interest (4.93%) Apr 1, 2022

Owned or controlled facilities with NPI records 8

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 7

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 3

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": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1063407534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 CRESTVIEW PARK DR STE 209",
            "city": "DICKSON",
            "state": "TN",
            "postal_code": "370552856",
            "telephone_number": "615-446-5121",
            "fax_number": "615-446-1359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 HIGHWAY 70 E STE 102",
            "city": "DICKSON",
            "state": "TN",
            "postal_code": "370552080",
            "telephone_number": "615-375-1531",
            "fax_number": "615-375-1526"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "895 Powers Blvd",
            "address_purpose": "LOCATION",
            "city": "Waverly",
            "state": "TN",
            "postal_code": "371851018",
            "country_code": "US",
            "telephone_number": "931-296-7552",
            "fax_number": "931-296-1209",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALSOUB",
        "first_name": "MOHAMMAD",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-12",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "TN",
            "license": "38437",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "TN",
            "license": "38437",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1516719",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3894698",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD TN",
            "identifier": "4138005",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "6060612",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "P00359629",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "103I295563",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dickson, TN

Sources for this page

Verify at the official NPI Registry.