Organization Active NPI

WT Medical Associates

  • Internal Medicine Physician
  • Dyersburg, TN
National Provider Identifier
1295223279
Registry record updated Oct 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
WT MEDICAL ASSOCIATES
Practice address
1629 Woodlawn Ave
Dyersburg, TN 38024
Phone
(731) 512-1277
Fax
(731) 285-1440
NPI assigned
Apr 25, 2018
Last updated
Oct 30, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2025

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

Authorized official

Name
Bartley Teague
Title
Executive Director
Phone
(731) 512-1277

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary
Physician Assistant 363A00000X
Medical Physician Assistant 363AM0700X
Nurse Practitioner 363L00000X
Acute Care Nurse Practitioner 363LA2100X
Adult Health Nurse Practitioner 363LA2200X
Family Nurse Practitioner 363LF0000X
Primary Care Nurse Practitioner 363LP2300X
Women's Health Nurse Practitioner 363LW0102X
Advanced Practice Midwife 367A00000X

Addresses

Primary practice location

1629 Woodlawn Ave
Dyersburg, TN 38024

Mailing address

257 Bancorp South Pkwy
Jackson, TN 38305-7582

Other practice location 1

455 E Parkview St
Dyersburg, TN 38024-3111
Phone (731) 285-2100

Other practice location 2

503 E Tickle St Ste A
Dyersburg, TN 38024-3165
Phone (731) 285-5244

Other practice location 3

420 Wilkinson Dr Fl 2
Dyersburg, TN 38024-2085
Phone (731) 285-5133

Other practice location 4

1716 Parr Ave Ste B
Dyersburg, TN 38024-2074
Phone (731) 288-3375

Other practice location 5

462 S Church St
Halls, TN 38040-1555
Phone (731) 836-9303

Other practice location 6

1718 Parr Ave Ste E
Dyersburg, TN 38024-2071
Phone (731) 288-2452

Other practice location 7

1718 Parr Ave Ste C
Dyersburg, TN 38024-2075
Phone (731) 288-2447

Other practice location 8

21 Meridian Springs Dr
Jackson, TN 38301-5900
Phone (731) 256-0526

Other practice location 9

143 Kennedy Dr
Martin, TN 38237-3309
Phone (731) 587-5321

Other practice location 10

1716 Parr Ave Ste C
Dyersburg, TN 38024-2074
Phone (731) 285-2324

Other practice location 11

379 Hospital Blvd
Jackson, TN 38305-2080
Phone (731) 660-5160

Other practice location 12

31 Physicians Dr
Jackson, TN 38305-2071
Phone (731) 668-9791

Other practice location 13

1270 Union University Dr Ste A
Jackson, TN 38305-3856
Phone (731) 664-0103

Other practice location 14

1718 Parr Ave Ste B
Dyersburg, TN 38024-2075
Phone (731) 286-4445

Other practice location 15

1716 Parr Ave Ste F
Dyersburg, TN 38024-2074
Phone (731) 285-1933

Other practice location 16

1718 Parr Ave Ste A
Dyersburg, TN 38024-2075
Phone (731) 285-4104

Other practice location 17

1055 Vendall Rd Ste A
Dyersburg, TN 38024-1622
Phone (731) 285-9938

Other identifiers 1

IdentifierTypeStateIssuer
Q037006MedicaidTN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180814002772 TN Part B Supplier - Clinic/Group Practice 1951650613 Receives reassigned benefits from 107 practitioners
3 other NPIs on this enrollment
Practice locations: Jackson, TN; Martin, TN; MC Kenzie, TN; Paris, TN; Ridgely, TN; Ripley, TN; Buchanan, TN; Camden, TN…

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 3

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D1042921WT Medical Associates Dba West Tennessee Medical1716 Parr Ave Ste F, Dyersburg, TN 38024Certificate of waiverJul 11, 2027
44D1082526WT Medical Associates Dba West Tennessee Medical1629 Woodlawn Ave, Dyersburg, TN 38024Certificate of waiverApr 10, 2028
44D2007405WT Medical Associates Dba West Tennessee Medical1718 Parr Ave, Suite a, Dyersburg, TN 38024Certificate of waiverMay 16, 2028
44D2033080WT Medical Associates Dba West Tennessee Medical1718 Parr Avenue Suite E, Dyersburg, TN 38024Certificate of waiverNov 21, 2027
44D2033550WT Medical Associates Dba West Tennessee1716 Parr Avenue Suite B, Dyersburg, TN 38024Certificate of waiverDec 5, 2027
44D2131805WT Medical Associates Dba West Tennessee Medical1270 Union University Drive Unit a, Jackson, TN 38305Certificate of waiverJun 5, 2027

National Provider Directory

National Provider Directory

Locations

710 E Main St
Adamsville, TN 38310
Phone (731) 632-3383

1055 Vendall Rd
Ste A
Dyersburg, TN 38024

1716 Parr Ave
Ste F
Dyersburg, TN 38024
Phone (731) 285-1933

1718 Parr Ave
Ste D
Dyersburg, TN 38024
Phone (731) 288-3370

1718 Parr Ave
Ste E
Dyersburg, TN 38024
Phone (731) 288-2452

420 Wilkinson Dr
#2
Dyersburg, TN 38024

420 Wilkinson Dr
Fl 2
Dyersburg, TN 38024
Phone (731) 285-5133

445 E Parkview St
Dyersburg, TN 38024

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
West Tennessee Medical Group Primary Care & Women's HealthDyersburg, TN, CCN 448918 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2019
West Tennessee Medical Group Primary Care CamdenCamden, TN, CCN 883957 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2018
West Tennessee Medical Group Pediatrics Paris Henry CountyParis, TN, CCN 448976 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2024

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 113

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 113

NPI Registry JSON

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

{
    "created_epoch": "1524614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761782400000",
    "number": "1295223279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "257 BANCORP SOUTH PKWY",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383057582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1629 WOODLAWN AVE",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "38024",
            "telephone_number": "731-512-1277",
            "fax_number": "731-285-1440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "455 E Parkview St",
            "address_purpose": "LOCATION",
            "city": "Dyersburg",
            "state": "TN",
            "postal_code": "380243111",
            "country_code": "US",
            "telephone_number": "731-285-2100",
            "fax_number": "731-285-6419",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "503 E Tickle St Ste A",
            "address_purpose": "LOCATION",
            "city": "Dyersburg",
            "state": "TN",
            "postal_code": "380243165",
            "country_code": "US",
            "telephone_number": "731-285-5244",
            "fax_number": "731-288-3379",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "420 Wilkinson Dr Fl 2",
            "address_purpose": "LOCATION",
            "city": "Dyersburg",
            "state": "TN",
            "postal_code": "380242085",
            "country_code": "US",
            "telephone_number": "731-285-5133",
            "fax_number": "731-285-6028",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1716 Parr Ave Ste B",
            "address_purpose": "LOCATION",
            "city": "Dyersburg",
            "state": "TN",
            "postal_code": "380242074",
            "country_code": "US",
            "telephone_number": "731-288-3375",
            "fax_number": "731-288-3379",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "462 S Church St",
            "address_purpose": "LOCATION",
            "city": "Halls",
            "state": "TN",
            "postal_code": "380401555",
            "country_code": "US",
            "telephone_number": "731-836-9303",
            "fax_number": "731-836-8603",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1718 Parr Ave Ste E",
            "address_purpose": "LOCATION",
            "city": "Dyersburg",
            "state": "TN",
            "postal_code": "380242071",
            "country_code": "US",
            "telephone_number": "731-288-2452",
            "fax_number": "731-288-3371",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1718 Parr Ave Ste C",
            "address_purpose": "LOCATION",
            "city": "Dyersburg",
            "state": "TN",
            "postal_code": "380242075",
            "country_code": "US",
            "telephone_number": "731-288-2447",
            "fax_number": "731-288-2448",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "21 Meridian Springs Dr",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "TN",
            "postal_code": "383015900",
            "country_code": "US",
            "telephone_number": "731-256-0526",
            "fax_number": "731-256-1720",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "143 Kennedy Dr",
            "address_purpose": "LOCATION",
            "city": "Martin",
            "state": "TN",
            "postal_code": "382373309",
            "country_code": "US",
            "telephone_number": "731-587-5321",
            "fax_number": "731-587-2555",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1716 Parr Ave Ste C",
            "address_purpose": "LOCATION",
            "city": "Dyersburg",
            "state": "TN",
            "postal_code": "380242074",
            "country_code": "US",
            "telephone_number": "731-285-2324",
            "fax_number": "731-285-1440",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "379 Hospital Blvd",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "TN",
            "postal_code": "383052080",
            "country_code": "US",
            "telephone_number": "731-660-5160",
            "fax_number": "731-984-8358",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "31 Physicians Dr",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "TN",
            "postal_code": "383052071",
            "country_code": "US",
            "telephone_number": "731-668-9791",
            "fax_number": "731-512-3548",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1270 Union University Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "TN",
            "postal_code": "383053856",
            "country_code": "US",
            "telephone_number": "731-664-0103",
            "fax_number": "731-265-6448",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1718 Parr Ave Ste B",
            "address_purpose": "LOCATION",
            "city": "Dyersburg",
            "state": "TN",
            "postal_code": "380242075",
            "country_code": "US",
            "telephone_number": "731-286-4445",
            "fax_number": "731-286-4452",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1716 Parr Ave Ste F",
            "address_purpose": "LOCATION",
            "city": "Dyersburg",
            "state": "TN",
            "postal_code": "380242074",
            "country_code": "US",
            "telephone_number": "731-285-1933",
            "fax_number": "731-285-1934",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1718 Parr Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Dyersburg",
            "state": "TN",
            "postal_code": "380242075",
            "country_code": "US",
            "telephone_number": "731-285-4104",
            "fax_number": "731-285-8157",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1055 Vendall Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Dyersburg",
            "state": "TN",
            "postal_code": "380241622",
            "country_code": "US",
            "telephone_number": "731-285-9938",
            "fax_number": "731-287-9764",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WT MEDICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-25",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A",
        "authorized_official_last_name": "TEAGUE",
        "authorized_official_first_name": "BARTLEY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "731-512-1277"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q037006",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dyersburg, TN

Sources for this page

Verify at the official NPI Registry.