Individual provider Active NPI

Randy Rushing, MSN, NP-C

  • Family Nurse Practitioner
  • Dyersburg, TN
National Provider Identifier
1639937493
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
35796 Issued in TN
Practice address
400 E Tickle St
Dyersburg, TN 38024-3120
Phone
(731) 285-2410
NPI assigned
Mar 7, 2024
Last updated
Jun 4, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 35796 TN Primary

Addresses

Primary practice location

400 E Tickle St
Dyersburg, TN 38024-3120

Mailing address

400 E Tickle St
Dyersburg, TN 38024-3120
Phone (731) 285-2410

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
I20240709000632 TN Practitioner - Nurse Practitioner 0648715219 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fast Pace Medical Clinic PLLCGroup PAC ID 5395881841, 737 clinicians
T M Carr MD PCGroup PAC ID 3375504913, 19 clinicians

Practice addresses (Care Compare)

2634 N Central Ave
Humboldt, TN 38343-1534
Phone (731) 324-1526

400 E Tickle St
Dyersburg, TN 38024-3120
Phone (731) 285-2410

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fast Pace Medical Clinic PLLC CurrentSince Feb 20, 2025 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Feb 20, 2025 Accepting new patients
Upperline Healthcare, PC CurrentSince Sep 1, 2025 Accepting new patients
Upperline Healthcare, PC CurrentSince Sep 1, 2025 Accepting new patients
T M Carr MD PC CurrentSince Apr 26, 2024 Accepting new patients

Locations

7348 E Brainerd Rd
Chattanooga, TN 37421
Phone (205) 822-8038

400 E Tickle St
Dyersburg, TN 38024
Phone (731) 285-2410

400 E Tickle St
Ste 1
Dyersburg, TN 38024

2634 N Central Ave
Humboldt, TN 38343
Phone (731) 324-1526

108 Courtright Rd
Martin, TN 38237
Phone (731) 281-4183

3960 New Covington Pike
Memphis, TN 38128
Phone (901) 516-5200

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1709769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1639937493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E TICKLE ST",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380243120",
            "telephone_number": "731-285-2410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E TICKLE ST",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380243120",
            "telephone_number": "731-285-2410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSHING",
        "first_name": "RANDY",
        "credential": "MSN, NP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-03-07",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "35796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dyersburg, TN

Sources for this page

Verify at the official NPI Registry.