Individual provider Active NPI

Joshua Mark Diltz, PA-S

  • Physician Assistant
  • Morristown, TN
National Provider Identifier
1528697190
Registry record updated Sep 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4653 Issued in TN
Practice address
291 S Daisy St
Morristown, TN 37813-2362
Phone
(423) 616-8315
Fax
(423) 616-8316
NPI assigned
Apr 6, 2020
Last updated
Sep 2, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2021

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 4653 TN Primary

Addresses

Primary practice location

291 S Daisy St
Morristown, TN 37813-2362

Mailing address

3301 Clearview St
Knoxville, TN 37917-2706
Phone (505) 610-5925

Other practice location 1

302b Tyson Avenue
Paris, TN 38242
Phone (505) 610-5925

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
I20210909001153 TN Practitioner - Physician Assistant 5496151920 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fast Pace Medical Clinic PLLCGroup PAC ID 5395881841, 737 clinicians

Practice addresses (Care Compare)

100 E Tennessee St
Collinwood, TN 38450
Phone (931) 724-9000

165 Rutledge Pike
Blaine, TN 37709-2417
Phone (865) 263-8370

2960 Winfield Dunn Pkwy
Kodak, TN 37764-4309
Phone (865) 213-7104

350 S Charles G Seivers Blvd
Clinton, TN 37716-3929
Phone (865) 290-2313

441 S Illinois Ave
Oak Ridge, TN 37830-7510
Phone (865) 685-0767

4696 Nashville Hwy
Chapel Hill, TN 37034-2110
Phone (931) 364-5321

5326 Western Ave
Knoxville, TN 37921-3203
Phone (865) 500-6526

7234 Tazewell Pike
Corryton, TN 37721-3550
Phone (865) 213-7132

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4653TNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Fast Pace Medical Clinic PLLC CurrentSince Aug 30, 2021 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Aug 30, 2021 Accepting new patients
Upperline Healthcare, PC CurrentSince Nov 1, 2025 Accepting new patients
Upperline Healthcare, PC CurrentSince Nov 1, 2025 Accepting new patients

Locations

7348 E Brainerd Rd
Chattanooga, TN 37421
Phone (205) 822-8038

291 S Daisy St
Morristown, TN 37813
Phone (423) 616-8315

Organizations & group practices 4

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": "1586131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1528697190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 CLEARVIEW ST",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379172706",
            "telephone_number": "505-610-5925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "291 S DAISY ST",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378132362",
            "telephone_number": "423-616-8315",
            "fax_number": "423-616-8316"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "302b Tyson Avenue",
            "address_purpose": "LOCATION",
            "city": "Paris",
            "state": "TN",
            "postal_code": "38242",
            "country_code": "US",
            "telephone_number": "505-610-5925",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DILTZ",
        "first_name": "JOSHUA",
        "middle_name": "MARK",
        "name_prefix": "Mr.",
        "credential": "PA-S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-06",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "4653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morristown, TN

Sources for this page

Verify at the official NPI Registry.