Active NPI
Nicholas Phillip Blevens, PHYSICIAN ASSISTANT
- Physician Assistant
- Hendersonville, TN
National Provider Identifier
1639801525
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5039
- Practice address
- 103 Hazel Path
Hendersonville, TN 37075-1602 - Phone
- (615) 991-3158
- NPI assigned
- Jun 29, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5039 | TN | Primary |
Addresses
Primary practice location
103 Hazel Path
Hendersonville, TN 37075-1602
Mailing address
801 Inverness Ave Apt B9
Nashville, TN 37204-2736
Phone (615) 478-7335
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5039 | TN | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Optimum Men'S Health PLLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Hendersonville, TN
- NPI 1306327887
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656460800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656460800000",
"number": "1639801525",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "801 INVERNESS AVE APT B9",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372042736",
"telephone_number": "615-478-7335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103 HAZEL PATH",
"city": "HENDERSONVILLE",
"state": "TN",
"postal_code": "370751602",
"telephone_number": "615-991-3158"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLEVENS",
"first_name": "NICHOLAS",
"middle_name": "PHILLIP",
"name_prefix": "Mr.",
"credential": "PHYSICIAN ASSISTANT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-06-29",
"last_updated": "2022-06-29",
"certification_date": "2022-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TN",
"license": "5039",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hendersonville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.