Active NPI
Tevri Tayip
- Physician Assistant
- Brentwood, TN
National Provider Identifier
1609593573
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA0000005832
- Practice address
- 9019 Overlook Blvd Ste C1B
Brentwood, TN 37027-2737 - Phone
- (615) 274-9767
- NPI assigned
- Oct 21, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5832 | TN | |
| Physician Assistant | 363A00000X | PA0000005832 | TN | Primary |
Addresses
Primary practice location
9019 Overlook Blvd Ste C1B
Brentwood, TN 37027-2737
Mailing address
9019 Overlook Blvd Ste C1B
Brentwood, TN 37027-2737
Phone (615) 274-9767
Other practice location 1
4365 Hillside Oaks
Montgomery, AL 36109-3169
Phone (615) 720-1223
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN, CO, MI, VA, MA, WI, WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 7
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2024
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
7877 Willow Chase Blvd
Houston, TX 77070-5934
9 Executive Campus
Cherry Hill, NJ 08002-4502
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5832 | TN | MD | Occupational Therapist |
| PA0000005832 | TN | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Iris Wound Care, PC | Past | Accepting new patients |
Organizations & group practices 7
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.
-
- Primary Care Clinic/Center
- Brentwood, TN
- NPI 1851025902
-
- Psychiatry Physician
- Dearborn, MI
- NPI 1053172866
-
- Internal Medicine Physician
- Dearborn, MI
- NPI 1851144877
-
- Family Medicine Physician
- Houston, TX
- NPI 1558118026
CO, MA, TN, VA, WA, WI
-
- Clinic/Center
- Brentwood, TN
- NPI 1568273605
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666310400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712016000000",
"number": "1609593573",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9019 OVERLOOK BLVD STE C1B",
"city": "BRENTWOOD",
"state": "TN",
"postal_code": "370272737",
"telephone_number": "615-274-9767"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9019 OVERLOOK BLVD STE C1B",
"city": "BRENTWOOD",
"state": "TN",
"postal_code": "370272737",
"telephone_number": "615-274-9767"
}
],
"practiceLocations": [
{
"address_1": "4365 Hillside Oaks",
"address_purpose": "LOCATION",
"city": "Montgomery",
"state": "AL",
"postal_code": "361093169",
"country_code": "US",
"telephone_number": "615-720-1223",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TAYIP",
"first_name": "TEVRI",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-10-21",
"last_updated": "2024-04-02",
"certification_date": "2024-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TN",
"license": "5832",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TN",
"license": "PA0000005832",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brentwood, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.