Individual provider Active NPI

Judith Anne Tessema

  • Family Medicine Physician
  • Bolivar, TN
National Provider Identifier
1083059265
Registry record updated Aug 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
62446 Issued in TN
Practice address
629 Nuckolls Rd
Bolivar, TN 38008-1599
Phone
(731) 658-3388
NPI assigned
May 1, 2013
Last updated
Aug 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A136409 CA
Family Medicine Physician 207Q00000X 62446 TN Primary

Addresses

Primary practice location

629 Nuckolls Rd
Bolivar, TN 38008-1599

Mailing address

629 Nuckolls Rd
Bolivar, TN 38008-1599
Phone (731) 658-3388

Other practice location 1

627 Nuckolls Rd
Bolivar, TN 38008
Phone (731) 600-1063

Other practice location 2

445 Nuckolls Rd
Bolivar, TN 38008-1539
Phone (731) 658-2902

Other practice location 3

1132 Industrial Dr
Henderson, TN 38340-1310
Phone (731) 983-3175

Other practice location 4

17 1st St E
Stanton, TN 38069-4426
Phone (731) 548-2232

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210202001549 TN Practitioner - Family Practice 5294037842 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Southwestern Medical School at Dallas, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1132 Industrial Dr
Henderson, TN 38340-1310
Phone (731) 983-3175

17 1St St E
Stanton, TN 38069-4426
Phone (731) 548-2232

627 Nuckolls Rd
Bolivar, TN 38008-1599
Phone (731) 658-3388

629 Nuckolls Rd
Bolivar, TN 38008-1599
Phone (731) 658-3388

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A136409CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hardeman County Community Health Center CurrentSince Jan 19, 2021 Accepting new patients
Hardeman County Community Health Center CurrentSince Jan 19, 2021 Accepting new patients

Locations

629 Nuckolls Rd
Bolivar, TN 38008
Phone (731) 658-3388

1132 Industrial Dr
Henderson, TN 38340
Phone (731) 983-3175

Interoperability endpoints

  • Direct secure messaging: jtessema55957@westdirect.optum.com
  • Direct secure messaging: judith.tessema.1@27086.direct.athenahealth.com
  • Direct secure messaging: judith.tessema.p1@direct.hcchc.nextgenshare.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": "1367366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786665600000",
    "number": "1083059265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629 NUCKOLLS RD",
            "city": "BOLIVAR",
            "state": "TN",
            "postal_code": "380081599",
            "telephone_number": "731-658-3388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 NUCKOLLS RD",
            "city": "BOLIVAR",
            "state": "TN",
            "postal_code": "380081599",
            "telephone_number": "731-658-3388"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "627 Nuckolls Rd",
            "address_purpose": "LOCATION",
            "city": "Bolivar",
            "state": "TN",
            "postal_code": "38008",
            "country_code": "US",
            "telephone_number": "731-600-1063",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "445 Nuckolls Rd",
            "address_purpose": "LOCATION",
            "city": "Bolivar",
            "state": "TN",
            "postal_code": "380081539",
            "country_code": "US",
            "telephone_number": "731-658-2902",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1132 Industrial Dr",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "TN",
            "postal_code": "383401310",
            "country_code": "US",
            "telephone_number": "731-983-3175",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17 1st St E",
            "address_purpose": "LOCATION",
            "city": "Stanton",
            "state": "TN",
            "postal_code": "380694426",
            "country_code": "US",
            "telephone_number": "731-548-2232",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TESSEMA",
        "first_name": "JUDITH",
        "middle_name": "ANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-01",
        "last_updated": "2026-08-14",
        "certification_date": "2026-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A136409",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "62446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolivar, TN

Sources for this page

Verify at the official NPI Registry.