Organization Active NPI

Synergy Medical Associates, PLLC

  • Primary Care Clinic/Center
  • Crossville, TN
National Provider Identifier
1083159966
Registry record updated Dec 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
SYNERGY MEDICAL ASSOCIATES, PLLC
Practice address
57 W Adams St
Crossville, TN 38555-4836
Phone
(931) 250-5433
Fax
(931) 250-5434
NPI assigned
Dec 30, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2023

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

Authorized official

Name
Joanna GibbsNPI 1558372862
Title
Owner
Phone
(931) 250-5433

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

57 W Adams St
Crossville, TN 38555-4836

Mailing address

57 W Adams St
Crossville, TN 38555-4836
Phone (931) 250-5433

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170207001098 TN Part B Supplier - Clinic/Group Practice 0547543019 Receives reassigned benefits from 2 practitioners
Practice locations: Crossville, TN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D2129791Synergy Medical Associates, PLLC57 West Adams Street, Crossville, TN 38555Certificate of waiverApr 24, 2027

National Provider Directory

National Provider Directory

Locations

88 Taylor Ave
Crossville, TN 38555
Phone (931) 250-5433

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1483056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703808000000",
    "number": "1083159966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 W ADAMS ST",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385554836",
            "telephone_number": "931-250-5433",
            "fax_number": "931-250-5434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 W ADAMS ST",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385554836",
            "telephone_number": "931-250-5433",
            "fax_number": "931-250-5434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYNERGY MEDICAL ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-30",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A",
        "authorized_official_last_name": "GIBBS",
        "authorized_official_first_name": "JOANNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "931-250-5433"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crossville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.