Individual provider Active NPI

Nicholas Alexander Tsambassis, M.D.

  • Internal Medicine Physician
  • Clarksville, TN
National Provider Identifier
1174628523
Registry record updated Mar 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD-019687 Issued in TN
Practice address
127 Dean Drive
Clarksville, TN 37040-3981
Phone
(931) 906-9473
Fax
(931) 906-9477
NPI assigned
Sep 13, 2006
Last updated
Mar 22, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X MD-019687 TN
Internal Medicine Physician 207R00000X MD-019687 TN Primary

Addresses

Primary practice location

127 Dean Drive
Clarksville, TN 37040-3981

Mailing address

127 Dean Drive
Clarksville, TN 37040-3981
Phone (931) 906-9473

Other identifiers 1

IdentifierTypeStateIssuer
103I118390OtherTNPTAN LOCAL PART B

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040819001553 TN Practitioner - Internal Medicine 4688648355 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-019687TNMDClinic Pharmacy

Practice roles

OrganizationSpecialtyStatusNew patients
Addiction Center of Nashville LLC CurrentSince Feb 24, 2019 Accepting new patients
Addiction Center of Nashville LLC CurrentSince Feb 24, 2019 Accepting new patients

Locations

1300 Hatcher Ln
Ste 5
Columbia, TN 38401
Phone (931) 548-3177

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20232/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521676800000",
    "number": "1174628523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 DEAN DRIVE",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370403981",
            "telephone_number": "931-906-9473",
            "fax_number": "931-906-9477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 DEAN DRIVE",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370403981",
            "telephone_number": "931-906-9473",
            "fax_number": "931-906-9477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSAMBASSIS",
        "first_name": "NICHOLAS",
        "middle_name": "ALEXANDER",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2018-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "TN",
            "license": "MD-019687",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD-019687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN LOCAL PART B",
            "identifier": "103I118390",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

Verify at the official NPI Registry.