Individual provider Active NPI

Michael E Parker, PA-C

  • Physician Assistant
  • Hohenwald, TN
National Provider Identifier
1568426567
Registry record updated May 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA0000000781 Issued in TN
Practice address
20 S Park St
Hohenwald, TN 38462-1413
Phone
(931) 796-7960
Fax
(931) 796-7790
NPI assigned
Apr 14, 2006
Last updated
May 20, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2010

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 PA0000000781 TN Primary

Addresses

Primary practice location

20 S Park St
Hohenwald, TN 38462-1413

Mailing address

PO Box 5
Hohenwald, TN 38462-0005
Phone (931) 796-7960

Other identifiers 2

IdentifierTypeStateIssuer
4058697OtherTNBLUE CROSS OF TENNESSEE
3715488MedicaidTN

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
I20100901000506 TN Practitioner - Physician Assistant 7012012602 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Nebraska College of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

20 S Park St
Hohenwald, TN 38462-1413
Phone (931) 796-7960

Hospital & facility affiliations

National Provider Directory

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

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Hohenwald Medical CenterHohenwald, TN, CCN 448950 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
General Partnership Interest
Oct 23, 2021
Oct 23, 2021

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274313600000",
    "number": "1568426567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5",
            "city": "HOHENWALD",
            "state": "TN",
            "postal_code": "384620005",
            "telephone_number": "931-796-7960",
            "fax_number": "931-796-7790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 S PARK ST",
            "city": "HOHENWALD",
            "state": "TN",
            "postal_code": "384621413",
            "telephone_number": "931-796-7960",
            "fax_number": "931-796-7790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "MICHAEL",
        "middle_name": "E",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-14",
        "last_updated": "2010-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "PA0000000781",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF TENNESSEE",
            "identifier": "4058697",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3715488",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hohenwald, TN

Sources for this page

Verify at the official NPI Registry.