Preston Parker Embrey, PA
Individual provider Active NPI Physician Assistant · Selmer, TN
NPI 1104059765 · NPPES record last updated Jul 9, 2025
Key facts
- NPI
- 1104059765
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 1768 (TN)
- Practice address
- 270 E Court Ave
Selmer, TN 38375-2304 - Phone
- (731) 541-9490
- NPI assigned
- Aug 31, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 14
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20091215000314 | TN | Practitioner - Physician Assistant | 1052451515 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1768 | TN | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Amg-Crockett, LLC | Current |
Accepting new patients | |
| West Tennessee Medical Group Inc | Current |
Accepting new patients | |
| Amg Hillside LLC | Current |
Accepting new patients | |
| Crossroads Urgent Care PLLC | Physician Assistant | Current |
Accepting new patients |
| WT Medical Associates | Current |
Accepting new patients | |
| WT Medical Associates | Current |
Accepting new patients | |
| Amg-Crockett LLC | Current |
Accepting new patients | |
| Crossroads Urgent Care PLLC | Physician Assistant | Current |
Accepting new patients |
| Amg-Hillside LLC | Current |
Accepting new patients | |
| Tullahoma Physicians Group, PLLC | Past | Accepting new patients | |
| Dyersburg HBP Medical Group LLC | Physician Assistant | Past | Accepting new patients |
Locations
710 E Main St
Adamsville, TN 38310
Phone (731) 632-3383
10160 Highway 64
Bolivar, TN 38008
Phone (423) 975-5455
420 Wilkinson Dr
Fl 2
Dyersburg, TN 38024
Phone (731) 285-5133
1718 Parr Ave
Ste C
Dyersburg, TN 38024
Phone (731) 285-3338
503 E Tickle St
Ste A
Dyersburg, TN 38024
Phone (731) 285-5244
400 E Tickle St
Dyersburg, TN 38024
Phone (731) 285-2410
426 White Ave
Henderson, TN 38340
Phone (731) 989-2174
1270 Union University Dr
Ste A
Jackson, TN 38305
Phone (731) 664-0103
101 Jackson Walk Plz
Jackson, TN 38301
Phone (731) 421-6950
620 Skyline Dr
Jackson, TN 38301
Phone (731) 541-4923
257 Bancorp South Pkwy
Jackson, TN 38305
Phone (731) 512-1283
100 Cherrywood Pl
Jackson, TN 38305
Phone (731) 541-4923
200 Birch St
Jackson, TN 38301
Phone (731) 422-5641
192 Prosser Rd
Lawrenceburg, TN 38464
Phone (931) 762-2332
106 S Military St
#B
Loretto, TN 38469
Phone (931) 853-4622
2445 Memorial Blvd
Ste C
Murfreesboro, TN 37129
Phone (615) 217-6900
1255 E College St
Ste 500
Pulaski, TN 38478
Phone (931) 363-8055
1275 E College St
Ste 2
Pulaski, TN 38478
Phone (931) 363-3514
204 Hillside Dr
Pulaski, TN 38478
Phone (931) 363-3514
270 E Court Ave
#B
Selmer, TN 38375
Phone 73164579322931
Interoperability endpoints
- preston.embrey.1@19363.direct.athenahealth.com
- https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
- hum7863@yourcarecommunity.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 1768 | TN | |
| Physician Assistant | 363A00000X | 1768 | TN | Yes |
Addresses
Primary practice location
270 E Court Ave
Selmer, TN 38375-2304
Mailing address
257 Bancorp South Pkwy # Tn38305
Jackson, TN 38305-7582
Phone (731) 660-8759
Other practice location 1
1718 Parr Ave Ste C
Dyersburg, TN 38024-2071
Phone (731) 286-4445
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1516451 | Medicaid | TN | |
| 4245228 | Other | TN | BCBS PA |
| 4245266 | Other | TN | BCBS PA SURGERY |
Other providers in Selmer, TN
- Dr. Joseph J. Driscoll, O.D.
- Dr. Joseph J. Driscoll, O.D.
- Joseph J. Driscoll
- Megan Dunaway
- William Andrew Eason
- Evergreen Center for Counseling, Inc
- Evolve Counseling, PLLC
- Family Clinic of Selmer, PC
- Fast Pace Medical Clinic PLLC
- Fast Pace Medical Clinic, PLLC
All providers in Selmer, TN · 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 Jul 9, 2025. 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.