NPIMap

Organization Active NPI

Physynergy, LLC

  • Anesthesiology Physician
  • Shelbyville, TN
National Provider Identifier
1124455969
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
PHYSYNERGY, LLC
Practice address
2835 Highway 231 N
Shelbyville, TN 37160-7327
Phone
(256) 429-5071
Fax
(256) 429-4674
NPI assigned
Oct 10, 2013
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Timothy Killen Adams Jr., MDNPI 1891749107
Title
President
Phone
(256) 429-5071

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X AL
Anesthesiologist Assistant 367H00000X AL
Anesthesiology Physician 207L00000X AL Primary
Pain Medicine (Anesthesiology) Physician 207LP2900X AL

Addresses

Primary practice location

2835 Highway 231 N
Shelbyville, TN 37160-7327

Mailing address

PO Box 52404
Lafayette, LA 70505-2404
Phone (706) 860-2701

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131127000891 TN Part B Supplier - Clinic/Group Practice 6204081292 Receives reassigned benefits from 56 practitioners
1 other NPI on this enrollment
Practice locations: Shelbyville, TN

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Physynergy LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 95

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 95

NPI Registry JSON

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

{
    "created_epoch": "1381363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1124455969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52404",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705052404",
            "telephone_number": "706-860-2701",
            "fax_number": "706-860-7973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2835 HIGHWAY 231 N",
            "city": "SHELBYVILLE",
            "state": "TN",
            "postal_code": "371607327",
            "telephone_number": "256-429-5071",
            "fax_number": "256-429-4674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSYNERGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-10",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "KILLEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "256-429-5071",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": null,
            "primary": false
        },
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "AL",
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AL",
            "license": null,
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "AL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelbyville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.