NPIMap

Individual provider Active NPI

John David Tullos, M.D.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Dickson, TN
National Provider Identifier
1104138908
Registry record updated Mar 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
54403 Issued in TN
Practice address
127 Crestview Park Dr Ste 204
Dickson, TN 37055-2856
Phone
(615) 441-4545
Fax
(615) 441-4505
NPI assigned
Jul 8, 2010
Last updated
Mar 17, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 54403 TN
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 54403 TN Primary

Addresses

Primary practice location

127 Crestview Park Dr Ste 204
Dickson, TN 37055-2856

Mailing address

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

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
I20160810001291 TN Practitioner - Sports MedicinePractitioner - Orthopedic Surgery 9739311812 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Orthopedic Surgery
Education
University of Mississippi School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Amg-Hillside LLCGroup PAC ID 9436240017, 25 clinicians

Practice addresses (Care Compare)

1275 E College St
Suite 2
Pulaski, TN 38478-4545
Phone (931) 363-3514

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Amg-Hillside LLC Orthopaedic Surgery CurrentSince Apr 1, 2024 Accepting new patients
Amg-Hillside LLC CurrentSince Apr 1, 2024 Accepting new patients
Amg-Hillside LLC Orthopaedic Surgery Current Accepting new patients
Dickson Medical Associates, PC Past Accepting new patients
Amg Hillside LLC Orthopaedic Surgery Past Accepting new patients

Locations

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

1275 E College St
Ste 2
Pulaski, TN 38478
Phone (931) 363-3514

202 Hillside Dr
Pulaski, TN 38478
Phone (931) 207-8397

204 Hillside Dr
Pulaski, TN 38478
Phone (931) 363-3514

Interoperability endpoints

  • Direct secure messaging: john.tullos.1@19363.direct.athenahealth.com

Organizations & group practices 5

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 9

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": "1278547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647475200000",
    "number": "1104138908",
    "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": "127 CRESTVIEW PARK DR STE 204",
            "city": "DICKSON",
            "state": "TN",
            "postal_code": "370552856",
            "telephone_number": "615-441-4545",
            "fax_number": "615-441-4505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TULLOS",
        "first_name": "JOHN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-08",
        "last_updated": "2022-03-17",
        "certification_date": "2022-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TN",
            "license": "54403",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "TN",
            "license": "54403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dickson, TN

Sources for this page

Verify at the official NPI Registry.