Individual provider Active NPI

Daniel Kyle Patterson, ACNPC-AG

  • Nurse Practitioner
  • Columbia, TN
National Provider Identifier
1619786373
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
207503 Issued in TN
Practice address
1224 Trotwood Ave
Columbia, TN 38401-4802
Phone
(931) 380-4072
Fax
(931) 490-7043
NPI assigned
Jan 6, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 207503 TN Primary

Addresses

Primary practice location

1224 Trotwood Ave
Columbia, TN 38401-4802

Mailing address

1224 Trotwood Ave
Columbia, TN 38401-4802
Phone (931) 380-4072

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
I20250228001783 TN Practitioner - Nurse Practitioner 4688194061 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Alabama School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maury Regional Medical Group, IncGroup PAC ID 7911810742, 119 clinicians

Practice addresses (Care Compare)

1224 Trotwood Ave
Columbia, TN 38401-4802
Phone (931) 381-1111

Hospital & facility affiliations

  • Maury Regional Hospital Hospital, Columbia, TN, CCN 440073
  • Southern Tennessee Regional Health System Lawrence Hospital, Lawrenceburg, TN, CCN 440175

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
207503TNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Maury Regional Hospital Marshall Medical Center CurrentSince Feb 1, 2025 Accepting new patients
Maury Regional Medical Group, Inc CurrentSince Feb 1, 2025 Accepting new patients

Locations

1224 Trotwood Ave
Columbia, TN 38401
Phone (931) 380-4072

854 W James M Campbell Blvd
Ste 303
Columbia, TN 38401
Phone (931) 388-8779

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1736121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1619786373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1224 TROTWOOD AVE",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384014802",
            "telephone_number": "931-380-4072",
            "fax_number": "931-490-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1224 TROTWOOD AVE",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384014802",
            "telephone_number": "931-380-4072",
            "fax_number": "931-490-7043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "DANIEL",
        "middle_name": "KYLE",
        "credential": "ACNPC-AG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-06",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "207503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, TN

Sources for this page

Verify at the official NPI Registry.