Gary Michael, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0101045149 Issued in VA

Practice address

210 Westwood PL Ste 110
Brentwood, TN 37027-7554

Phone

(615) 206-2462

Fax

(833) 983-2043

NPI assigned

Jan 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gmichael@landmarkhealth-direct.org

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.

• Dedicated Physicians Group of Tennessee, PLLC

  • Non-Pharmacy Dispensing Site
  • Miami, FL
  • NPI 1174144695

  TN

  Medicare reassignment NPD
• Medical Education Assistance Corporation

  • Family Medicine Physician
  • Kingsport, TN
  • NPI 1588786768
  NPD (past)

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

{
    "created_epoch": "1136419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1376521708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 E RAVINE RD",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603814",
            "telephone_number": "423-245-9600",
            "fax_number": "423-245-9634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 WESTWOOD PL STE 110",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277554",
            "telephone_number": "615-206-2462",
            "fax_number": "833-983-2043"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "102 E Ravine Rd",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376603814",
            "country_code": "US",
            "telephone_number": "423-845-9600",
            "fax_number": "423-245-9634",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MICHAEL",
        "first_name": "GARY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-05",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101045149",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD26094",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1508847",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Kaku Miah, MD, MBA
• Micah Management LLC
• Folusho Micah
• Michael a. Boggess, MD, PLLC
• Michael R. Politzer, O.D., Co
• Sarah Urlacher Micklewright
• Middle Tennessee Dental Sleep Specialists PLLC
• Middle Tennessee Dental Sleep Specialists PLLC
• Middle Tennessee Pain Alliances, PLLC
• Middle Tennessee Prosthodontics, LLC

• Family Medicine Physician in Brentwood, TN
• Providers in Brentwood, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2022; 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.

Verify at the official NPI Registry.