Individual provider Active NPI

Martin J Fiala, MD

  • Orthopaedic Surgery Physician
  • Tullahoma, TN
National Provider Identifier
1619961976
Registry record updated Apr 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
MD26680 Issued in TN
Practice address
1816 N Washington St
Suite 100
Tullahoma, TN 37388-2222
Phone
(931) 455-8676
Fax
(931) 455-9983
NPI assigned
Sep 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X MD26680 TN Primary
Physical Medicine & Rehabilitation Physician 208100000X MD26680 TN
Surgery of the Hand (Surgery) Physician 2086S0105X MD26680 TN

Addresses

Primary practice location

1816 N Washington St
Suite 100
Tullahoma, TN 37388-2222

Mailing address

1816 N Washington St
Suite 100
Tullahoma, TN 37388-2222
Phone (931) 455-8676

Other identifiers 10

IdentifierTypeStateIssuer
0940299OtherUNITED HEALTH CARE
3093522OtherTNBLUE CROSS
682362OtherAETNA
200034386OtherRAILROAD MEDICARE
621738887002OtherPRUDENTIAL
TN0102OtherTNAMERICHOICE
10070490OtherTNAMERIGROUP
1536928OtherUMWA
3098802MedicaidTN
5541521OtherCIGNA

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
I20101117000490 TN Practitioner - Orthopedic Surgery 8729152483 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Amg-Southern Tennessee LLC CurrentSince Sep 1, 2018 Accepting new patients
Amg-Southern Tennessee LLC CurrentSince Sep 1, 2018 Accepting new patients
Amg-Crockett, LLC CurrentSince Jun 2, 2023 Accepting new patients
Amg-Crockett, LLC CurrentSince Jun 2, 2023 Accepting new patients

Locations

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

1605 S Locust Ave
Ste 101
Lawrenceburg, TN 38464
Phone (931) 762-4400

1275 E College St
Ste 2
Pulaski, TN 38478
Phone (931) 363-3514

83 Memorial Dr
Winchester, TN 37398
Phone (931) 967-3966

Interoperability endpoints

  • Direct secure messaging: martin.fiala.1@19363.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1125532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302134400000",
    "number": "1619961976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1816 N WASHINGTON ST",
            "address_2": "SUITE 100",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373882222",
            "telephone_number": "931-455-8676",
            "fax_number": "931-455-9983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1816 N WASHINGTON ST",
            "address_2": "SUITE 100",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373882222",
            "telephone_number": "931-455-8676",
            "fax_number": "931-455-9983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIALA",
        "first_name": "MARTIN",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-01",
        "last_updated": "2011-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TN",
            "license": "MD26680",
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TN",
            "license": "MD26680",
            "primary": false
        },
        {
            "code": "2086S0105X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgery of the Hand",
            "state": "TN",
            "license": "MD26680",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "0940299",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "3093522",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "682362",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "200034386",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRUDENTIAL",
            "identifier": "621738887002",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE",
            "identifier": "TN0102",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "10070490",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMWA",
            "identifier": "1536928",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3098802",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "5541521",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tullahoma, TN

Sources for this page

Verify at the official NPI Registry.