NPIMap

Individual provider Active NPI

John D Patsimas, MD

  • Family Medicine Physician
  • Tullahoma, TN
National Provider Identifier
1649376849
Registry record updated Mar 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD024651 Issued in TN
Practice address
100 William Northern Blvd
Tullahoma, TN 37388-4754
Phone
(931) 454-0489
Fax
(931) 454-2348
NPI assigned
Sep 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD024651 TN Primary

Addresses

Primary practice location

100 William Northern Blvd
Tullahoma, TN 37388-4754

Mailing address

100 William Northern Blvd
Tullahoma, TN 37388-4754
Phone (931) 454-0489

Other identifiers 2

IdentifierTypeStateIssuer
4314519OtherTNBCBS
3880243MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040525000436 TN Practitioner - Family Practice 0042201337 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Practice Center of Tullahoma LLCGroup PAC ID 2769640812, 6 clinicians

Practice addresses (Care Compare)

100 William N Blvd
Tullahoma, TN 37388-4754
Phone (931) 454-0489

Hospital & facility affiliations

  • Aveanna Home Health Home health agency, Murfreesboro, TN, CCN 447163
  • NHC Homecare Murfreesboro Home health agency, Murfreesboro, TN, CCN 447114
  • Adoration Home Health, LLC Home health agency, Madison, TN, CCN 447581
  • Centerwell Home Health Home health agency, MC Minnville, TN, CCN 447454
  • Enhabit Home Health Home health agency, Winchester, TN, CCN 447108
  • Vanderbilt Tullahoma-Harton Hospital Hospital, Tullahoma, TN, CCN 440144
  • Life Care Center of Tullahoma Nursing home, Tullahoma, TN, CCN 445238

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions17
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD024651TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tullahoma Immediate Care PC Family Medicine CurrentSince Jan 15, 2012 Accepting new patients
Family Practice Center of Tullahoma LLC Family Medicine CurrentSince Mar 1, 2012 Accepting new patients
Life Care Centers of America, Inc. Past Accepting new patients
St. Thomas Medical Group PLLC Past Accepting new patients

Locations

730 Kings Ln
Tullahoma, TN 37388
Phone (931) 393-2121

100 William Northern Blvd
Tullahoma, TN 37388
Phone (931) 454-0489

1210 S Jackson St
Tullahoma, TN 37388
Phone (931) 454-0489

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CBFIAA

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.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363737600000",
    "number": "1649376849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WILLIAM NORTHERN BLVD",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373884754",
            "telephone_number": "931-454-0489",
            "fax_number": "931-454-2348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WILLIAM NORTHERN BLVD",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373884754",
            "telephone_number": "931-454-0489",
            "fax_number": "931-454-2348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATSIMAS",
        "first_name": "JOHN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2013-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD024651",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4314519",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3880243",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tullahoma, TN

Sources for this page

Verify at the official NPI Registry.