Individual provider Active NPI

Than Zaw Win Tin, MD

  • Internal Medicine Physician
  • Cleveland, TN
National Provider Identifier
1619943792
Registry record updated Aug 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
37877 Issued in TN
Practice address
2305 Chambliss Ave NW
Cleveland, TN 37311-3847
Phone
(423) 559-6000
Fax
(423) 559-6653
NPI assigned
Feb 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 37877 TN Primary

Addresses

Primary practice location

2305 Chambliss Ave NW
Cleveland, TN 37311-3847

Mailing address

7100 Commerce Way
Suite 180
Brentwood, TN 37067-6325
Phone (615) 465-7000

Other identifiers 6

IdentifierTypeStateIssuer
870588111BMedicaidGA
4134490OtherTNBCBS
870588111AMedicaidGA
7054406OtherTNCIGNA
3890226MedicaidTN
870588111CMedicaidGA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040109000972 TN Practitioner - Internal Medicine 7315847050 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Physician Services PCGroup PAC ID 0042307852, 591 clinicians

Practice addresses (Care Compare)

1201 Bishop St
Union City, TN 38261-5403
Phone (731) 885-2410

2305 Chambliss Ave NW
Cleveland, TN 37311-3847
Phone (423) 559-6000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
37877TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
App of Tennessee HM, PLLC CurrentSince Nov 11, 2019 Accepting new patients
Southeastern Physician Services PC Internal Medicine CurrentSince Jan 1, 2010 Accepting new patients
Greenville Proaxis Therapy, LLC Past Accepting new patients
Greenville Health System Past Accepting new patients
Cleveland Medical Clinic Inc Internal Medicine Past Accepting new patients
Ocoee Hospital Corporation Past Accepting new patients
Bradley Medical Center, LLC Past Accepting new patients

Locations

2305 Chambliss Ave NW
Cleveland, TN 37311
Phone (423) 559-6000

1 Medical Center Blvd
Cookeville, TN 38501
Phone (931) 783-2334

2835 Highway 231 N
Shelbyville, TN 37160
Phone (931) 685-5433

1201 Bishop St
Union City, TN 38261
Phone (423) 698-6061

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.

Hospital & facility affiliations 1

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": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218585600000",
    "number": "1619943792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7100 COMMERCE WAY",
            "address_2": "SUITE 180",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370676325",
            "telephone_number": "615-465-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2305 CHAMBLISS AVE NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373113847",
            "telephone_number": "423-559-6000",
            "fax_number": "423-559-6653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIN",
        "first_name": "THAN ZAW",
        "middle_name": "WIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2008-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "37877",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "870588111B",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4134490",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "870588111A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "7054406",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3890226",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "870588111C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, TN

Sources for this page

Verify at the official NPI Registry.