Individual provider Active NPI

Tasha Ruffin

  • Acute Care Nurse Practitioner
  • Portland, TN
National Provider Identifier
1083438568
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
37607 Issued in TN
Practice address
215 Highland Circle Dr
Portland, TN 37148-4918
Phone
(615) 325-9263
NPI assigned
Nov 12, 2024
Last updated
Nov 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 37607 TN Primary

Addresses

Primary practice location

215 Highland Circle Dr
Portland, TN 37148-4918

Mailing address

617 Coles Ferry Rd
Gallatin, TN 37066-6218

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
I20250205002776 TN Practitioner - Nurse Practitioner 9335679307 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
37607TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Ipc Pac Healthcare Services of Tennessee PC CurrentSince Dec 6, 2024 Accepting new patients
CS Pacs 3 Southeast, LLC CurrentSince Dec 6, 2024 Accepting new patients
BH Services Southeast 1 PC CurrentSince Mar 1, 2025 Accepting new patients
NV Pacs 2 LLC CurrentSince Dec 6, 2024 Accepting new patients

Locations

18 N Cavalier Dr
Alamo, TN 38001
Phone (731) 696-4500

880 S Mohawk Dr
Erwin, TN 37650
Phone (423) 743-7669

215 Highland Circle Dr
Portland, TN 37148
Phone (615) 325-9263

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1731369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1083438568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 COLES FERRY RD",
            "city": "GALLATIN",
            "state": "TN",
            "postal_code": "370666218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 HIGHLAND CIRCLE DR",
            "city": "PORTLAND",
            "state": "TN",
            "postal_code": "371484918",
            "telephone_number": "615-325-9263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUFFIN",
        "first_name": "TASHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-12",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TN",
            "license": "37607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, TN

Sources for this page

Verify at the official NPI Registry.