Individual provider Active NPI

Michael A Giblin, PA-C

  • Physician Assistant
  • White House, TN
National Provider Identifier
1366817611
Registry record updated Dec 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2920 Issued in TN
Practice address
491 Sage Rd N Ste 800
White House, TN 37188-9362
Phone
(615) 672-4089
Fax
(615) 672-7849
NPI assigned
Dec 10, 2015
Last updated
Dec 9, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2920 TN Primary

Addresses

Primary practice location

491 Sage Rd N Ste 800
White House, TN 37188-9362

Mailing address

491 Sage Rd N Ste 800
White House, TN 37188-9362
Phone (615) 672-4089

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160307001050 TN Practitioner - Physician Assistant 7315243011 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Crossroads Medical Group, PLLCGroup PAC ID 3779544895, 52 clinicians

Practice addresses (Care Compare)

491 Sage Rd N
Suite 200
White House, TN 37188-9361
Phone (615) 672-7122

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Diagnostic Imaging, PC Physician Assistant CurrentSince Aug 30, 2020 Accepting new patients
RHC Group PLLC CurrentSince Jan 1, 2024 Accepting new patients
Advanced Diagnostic Imaging PC CurrentSince Aug 30, 2020 Accepting new patients
Crossroads Medical Group, P.a. Past Accepting new patients

Locations

2557 Highway 41 S
Greenbrier, TN 37073
Phone (615) 643-4534

3443 Dickerson Pike
Ste 400
Nashville, TN 37207
Phone (615) 612-2146

491 Sage Rd N
Ste 200
White House, TN 37188
Phone (615) 581-5925

491 Sage Rd N
Ste 800
White House, TN 37188
Phone (615) 672-4089

Organizations & group practices 6

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": "1449705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765238400000",
    "number": "1366817611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "491 SAGE RD N STE 800",
            "city": "WHITE HOUSE",
            "state": "TN",
            "postal_code": "371889362",
            "telephone_number": "615-672-4089",
            "fax_number": "615-672-7849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "491 SAGE RD N STE 800",
            "city": "WHITE HOUSE",
            "state": "TN",
            "postal_code": "371889362",
            "telephone_number": "615-672-4089",
            "fax_number": "615-672-7849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBLIN",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-10",
        "last_updated": "2025-12-09",
        "certification_date": "2025-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "2920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White House, TN

Sources for this page

Verify at the official NPI Registry.