Individual provider Active NPI

John Thomas Fussell, PA-C

  • Medical Physician Assistant
  • Erin, TN
National Provider Identifier
1679265490
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5567 Issued in TN
Practice address
4891 E Main St
Erin, TN 37061-4115
Phone
(931) 289-4201
Fax
(931) 289-1947
NPI assigned
May 22, 2023
Last updated
Jun 9, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5567 TN Primary

Addresses

Primary practice location

4891 E Main St
Erin, TN 37061-4115

Mailing address

50 Hunter LN
Erin, TN 37061-4169
Phone (931) 289-9189

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
I20230807003079 TN Practitioner - Physician Assistant 7416318464 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hilcrest Clinic, PCGroup PAC ID 0446223457, 6 clinicians

Practice addresses (Care Compare)

4891 E Main St
Erin, TN 37061-4115
Phone (931) 289-4201

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5567TNMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Fast Pace Medical Clinic PLLC CurrentSince Jul 2, 2023 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Jul 2, 2023 Accepting new patients
Lexington Clinic Corp CurrentSince Nov 29, 2023 Accepting new patients
Shamrock Community Hospital Inc Past Accepting new patients
Lexington Hospital Corporation Past Accepting new patients
Lexington Hospital Corporation Past Accepting new patients
Lexington Family Physicians LLC Past Accepting new patients
Lexington Hospital Corporation Past Accepting new patients
Shamrock Community Hospital Inc Past Accepting new patients
Shamrock Community Hospital Inc. Past Accepting new patients

Locations

2545 N Washington Ave
Brownsville, TN 38012
Phone (731) 307-3777

2545 N Washington Ave
Ste 2
Brownsville, TN 38012

5001 E Main St
Erin, TN 37061
Phone (336) 944-6420

200 W Church St
Lexington, TN 38351
Phone (731) 968-1812

270 W Church St
Ste A
Lexington, TN 38351
Phone (731) 968-0133

301 W Main St
Waverly, TN 37185
Phone (931) 299-7378

Organizations & group practices 11

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": "1684713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1679265490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 HUNTER LN",
            "city": "ERIN",
            "state": "TN",
            "postal_code": "370614169",
            "telephone_number": "931-289-9189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4891 E MAIN ST",
            "city": "ERIN",
            "state": "TN",
            "postal_code": "370614115",
            "telephone_number": "931-289-4201",
            "fax_number": "931-289-1947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUSSELL",
        "first_name": "JOHN",
        "middle_name": "THOMAS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-22",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TN",
            "license": "5567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erin, TN

Sources for this page

Verify at the official NPI Registry.