Andrew Levi Blythe, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

2103 Forest Dr Ste 5
Gray, TN 37615-8423

Phone

(423) 794-3142

Fax

(423) 794-3184

NPI assigned

Dec 9, 2019

Last updated

May 13, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN, NV2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Centennial Medical Group LLPGroup PAC ID 6901807536, 10 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

96.58 of 100Reported as group

Quality

100

Improvement activities

40

Cost

67.97

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: andrewblythe@nvpainrelief.directglo.com

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.

• Centennial Medical Group LLP

  • Interventional Pain Medicine Physician
  • Las Vegas, NV
  • NPI 1073619359
  Medicare reassignment Care Compare group NPD
• Associated Pain Specialists, PC

  • Pain Medicine Physician
  • Knoxville, TN
  • NPI 1487075099
  Medicare reassignment
• Robert Odell MD PHD Medical Enterprises

  • Pain Medicine (Anesthesiology) Physician
  • Las Vegas, NV
  • NPI 1306124086
  Medicare reassignment
• Associated Pain Specialists, PC

  • Pain Medicine Physician
  • Morristown, TN
  • NPI 1679394514
  NPD
• Centennial Medical Group LLP

  • Durable Medical Equipment & Medical Supplies
  • Las Vegas, NV
  • NPI 1013807361
  NPD

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

{
    "created_epoch": "1575849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1336786383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1326 PAPERMILL POINTE WAY",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379091903",
            "telephone_number": "865-243-2136",
            "fax_number": "865-243-2138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2103 FOREST DR STE 5",
            "city": "GRAY",
            "state": "TN",
            "postal_code": "376158423",
            "telephone_number": "423-794-3142",
            "fax_number": "423-794-3184"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1342 Papermill Pointe Way",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379091903",
            "country_code": "US",
            "telephone_number": "865-673-5000",
            "fax_number": "865-588-5711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLYTHE",
        "first_name": "ANDREW",
        "middle_name": "LEVI",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-12-09",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "3961",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathy Beard
• Better Life Medical PC (Tennessee Men's Health)
• Kirk L Black, MA, THERAPIST
• Blue Ridge Medical Management Corporation (First Assist Urgent Care)
• Blue Ridge Medical Management Corporation (MSMG OB GYN Gray)
• Bruce D Boggs, MD
• Sherry Bolden, CPHT
• Tina Bowman, CSFA
• Sherry Brandon, L.M.T, B.S.
• Abigail Brown, PHARMD

• Physician Assistant in Gray, TN
• Providers in Gray, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.