Wilson Morris Massey III, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

10085 Issued in TN

Practice address

217 W Jefferson St
Pulaski, TN 38478-2812

Phone

(931) 363-1564

NPI assigned

Jun 19, 2015

Last updated

Oct 27, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective May 26, 2016 through May 26, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Dr. Tesa H. Jolly

  • General Practice Dentistry
  • Pulaski, TN
  • NPI 1518460500
  NPD (past)

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

{
    "created_epoch": "1434672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509062400000",
    "number": "1467834093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 W JEFFERSON ST",
            "city": "PULASKI",
            "state": "TN",
            "postal_code": "384782812",
            "telephone_number": "931-363-1564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 W JEFFERSON ST",
            "city": "PULASKI",
            "state": "TN",
            "postal_code": "384782812",
            "telephone_number": "931-363-1564"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "336 Robins St",
            "address_purpose": "LOCATION",
            "city": "Lawrenceburg",
            "state": "TN",
            "postal_code": "384642395",
            "country_code": "US",
            "telephone_number": "931-762-2894",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASSEY",
        "first_name": "WILSON",
        "middle_name": "MORRIS",
        "name_suffix": "III",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-19",
        "last_updated": "2017-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "10085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valerie S. Manning, M.S. CCC-SLP
• Martin Methodist Clinic
• Lani Marie Martin, DPT
• Mashburn Family Health, PLLC
• Beth Mason, COTA/L
• Matthew P McMasters
• Pamela McCord
• Jewel D McCoy, NURSE'S AIDE
• Michael E McDade
• Courtney Barrows McKeown, M.D.

• General Practice Dentistry in Pulaski, TN
• Providers in Pulaski, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2017; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.