Individual provider Active NPI

Heena Ismaili, PA-C

  • Physician Assistant
  • Murfreesboro, TN
National Provider Identifier
1669261772
Registry record updated May 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
6554 Issued in TN
Practice address
1301 E Main St
Murfreesboro, TN 37132-0002
Phone
(615) 494-7790
NPI assigned
May 5, 2025
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 6554 TN Primary

Addresses

Primary practice location

1301 E Main St
Murfreesboro, TN 37132-0002

Mailing address

1301 E Main St
Murfreesboro, TN 37132-0002
Phone (615) 494-7790

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
I20250625003074 TN Practitioner - Physician Assistant 8628580511 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fast Pace Medical Clinic PLLCGroup PAC ID 5395881841, 737 clinicians

Practice addresses (Care Compare)

100 E Tennessee St
Collinwood, TN 38450
Phone (931) 724-9000

890 Isabella LN
Smyrna, TN 37167-4215
Phone (615) 768-8021

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
6554TNMDAdult Psychiatric/Mental Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Upperline Healthcare, PC CurrentSince Sep 4, 2025 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince May 19, 2025 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince May 19, 2025 Accepting new patients
Upperline Healthcare, PC CurrentSince Sep 4, 2025 Accepting new patients

Locations

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

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": "1746403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746403200000",
    "number": "1669261772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 E MAIN ST",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371320002",
            "telephone_number": "615-494-7790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 E MAIN ST",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371320002",
            "telephone_number": "615-494-7790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISMAILI",
        "first_name": "HEENA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-05-05",
        "last_updated": "2025-05-05",
        "certification_date": "2025-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "6554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murfreesboro, TN

Sources for this page

Verify at the official NPI Registry.