Rudy Gary Hamm, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA0000000203TN Issued in TN

Practice address

1559 Highland Park Dr
Lenoir City, TN 37772-6237

Phone

(865) 635-8389

Fax

(865) 635-8390

NPI assigned

Jul 28, 2005

Last updated

Apr 25, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Specialty

Physician Assistant

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Physician Associate Resources, PLC

  dba Clinica Familiar Latinoamerica

  • Medical Physician Assistant
  • Lenoir City, TN
  • NPI 1811458565
  Medicare reassignment Authorized official
• Crossroads Urgent Care PLLC

  dba Urgent Team

  • Family Medicine Physician
  • Chattanooga, TN
  • NPI 1437194222
  NPD (past)
• Emergency Coverage Services, PC

  • Nurse Practitioner
  • Lawrenceburg, TN
  • NPI 1053351593
  NPD (past)
• Fast Access Healthcare

  • Internal Medicine Physician
  • Chattanooga, TN
  • NPI 1063619997
  NPD (past)
• Vision Healthcare Solutions LLC

  dba Grace Primary Care Clinic

  • Clinic/Center
  • Spring City, TN
  • NPI 1598552465
  NPD (past)

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587772800000",
    "number": "1649270844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1559 HIGHLAND PARK DR",
            "city": "LENOIR CITY",
            "state": "TN",
            "postal_code": "377726237",
            "telephone_number": "865-635-8389",
            "fax_number": "656-358-3908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1559 HIGHLAND PARK DR",
            "city": "LENOIR CITY",
            "state": "TN",
            "postal_code": "377726237",
            "telephone_number": "865-635-8389",
            "fax_number": "865-635-8390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMM",
        "first_name": "RUDY",
        "middle_name": "GARY",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2020-04-25",
        "certification_date": "2020-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TN",
            "license": "PA0000000203TN",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3669684",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://myupdox.com/ui/html/#/inbox",
            "affiliation": "N",
            "endpointDescription": "EFax,Direct Message",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Fax 9495774314",
            "address_1": "1559 Highland Park Dr",
            "city": "Lenoir City",
            "state": "TN",
            "country_code": "US",
            "postal_code": "377726237",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Melissa Halcomb, RMA
• Meredith Danielle Hale, MD
• Bethany Abb Hall, OTR/L
• Lillie Halsey
• Renee Marie Hamilton, MSN, FNP-BC
• Nancy Handly, RN
• Jennie R. Haney, CPNP
• Grace Harmon
• Melissa Ann Harrill, AAS
• Stephanie Wyrick Hartline, CST/CFA

• Medical Physician Assistant in Lenoir City, TN
• Providers in Lenoir City, TN by specialty
• Medical Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.