Active NPI
Nicholas Alexander Tsambassis, M.D.
- Internal Medicine Physician
- Clarksville, TN
National Provider Identifier
1174628523
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD-019687
- 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, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 103I118390 | Other | TN | PTAN 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD-019687 | TN | MD | Clinic Pharmacy |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Addiction Center of Nashville LLC | Current | Accepting new patients | |
| Addiction Center of Nashville LLC | Current | Accepting new patients |
Locations
1300 Hatcher Ln
Ste 5
Columbia, TN 38401
Phone (931) 548-3177
Interoperability endpoints
- 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.
-
dba Ruth Clinic
- Addiction Medicine (Internal Medicine) Physician
- Columbia, TN
- NPI 1649764911
-
- Primary Care Clinic/Center
- Clarksville, TN
- NPI 1528257532
-
- Addiction Medicine (Internal Medicine) Physician
- Mandeville, LA
- NPI 1760076871
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.