Individual provider Active NPI

Jack Christopher Thomason, DO

  • Emergency Medicine Physician
  • Hendersonville, TN
National Provider Identifier
1306167010
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2610 Issued in TN
Practice address
355 New Shackle Island Rd
Hendersonville, TN 37075
Phone
(615) 338-1258
NPI assigned
Jun 16, 2010
Sex
Male
Sole proprietor
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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 5101018860 MI
Emergency Medicine Physician 207P00000X 2610 TN Primary

Addresses

Primary practice location

355 New Shackle Island Rd
Hendersonville, TN 37075

Mailing address

355 New Shackle Island Rd
Hendersonville, TN 37075
Phone (615) 338-1258

Other practice location 1

1000 Oakland Dr
Kalamazoo, MI 49008-1282
Phone (269) 337-4400

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
I20140703001830 TN Practitioner - Emergency Medicine 3678798790 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101018860MIMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Services of TN, PC Emergency Medicine CurrentSince Apr 1, 2023 Accepting new patients
App of Tennessee Ed, PLLC Emergency Medicine CurrentSince Mar 12, 2019 Accepting new patients
Hospital Based Medical Services of Tennessee-I PC Emergency Medicine Past Accepting new patients

Locations

1 Medical Center Blvd
Cookeville, TN 38501
Phone (931) 783-2334

111 Highway 70 E
Dickson, TN 37055
Phone (615) 441-2357

355 New Shackle Island Rd
Hendersonvlle, TN 37075
Phone (615) 264-4000

907 Lamar Alexander Pkwy
Maryville, TN 37804
Phone (865) 766-8818

2300 Patterson St
Nashville, TN 37203
Phone (615) 342-1500

105 Redbud Dr
Portland, TN 37148
Phone (615) 325-1215

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1276646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1306167010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 NEW SHACKLE ISLAND RD",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "37075",
            "telephone_number": "615-338-1258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 NEW SHACKLE ISLAND RD",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "37075",
            "telephone_number": "615-338-1258"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Oakland Dr",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490081282",
            "country_code": "US",
            "telephone_number": "269-337-4400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMASON",
        "first_name": "JACK",
        "middle_name": "CHRISTOPHER",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-16",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "5101018860",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "2610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hendersonville, TN

Sources for this page

Verify at the official NPI Registry.