Ivy Lee Massengale, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

923 E Central Ave
La Follette, TN 37766-2768

Phone

(423) 907-1200

NPI assigned

Sep 5, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-usa.unify.chbase.com/org/sweet-8feb766f

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.

• Emergency Coverage Services, PC

  • Nurse Practitioner
  • Lawrenceburg, TN
  • NPI 1053351593
  Medicare reassignment
• Emergency Coverage, LLC

  • Family Medicine Physician
  • Newport, TN
  • NPI 1427005008
  Medicare reassignment
• Southeastern Emergency Services P C

  • Nurse Practitioner
  • Athens, TN
  • NPI 1669414264
  Medicare reassignment
• Sweetwater Hospital Association

  • Certified Registered Nurse Anesthetist
  • Sweetwater, TN
  • NPI 1629077532
  Medicare reassignment
• Southeastern Emergency Physicians LLC

  • Emergency Medicine Physician
  • Maysville, KY
  • NPI 1356379382

  TN

  Medicare reassignment
• Sweetwater Hospital Association

  • Rural Health Clinic/Center
  • Sweetwater, TN
  • NPI 1205659711
  NPD
• Sweetwater Hospital ER Physician Group

  • Emergency Medicine Physician
  • Sweetwater, TN
  • NPI 1083613905
  NPD

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

{
    "created_epoch": "1567641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577750400000",
    "number": "1689223489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2305 CRYSTAL SPRING LN",
            "city": "HERMITAGE",
            "state": "TN",
            "postal_code": "370764196",
            "telephone_number": "423-637-2504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "923 E CENTRAL AVE",
            "city": "LA FOLLETTE",
            "state": "TN",
            "postal_code": "377662768",
            "telephone_number": "423-907-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSENGALE",
        "first_name": "IVY",
        "middle_name": "LEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-05",
        "last_updated": "2019-12-31",
        "certification_date": "2019-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "934",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Madron
• Elie Mansour, M.D.
• Elizabeth Marlow, APRN
• Heidi M Marlow, AGNP-CB
• Carol Ann Marshall, APRN BC PSYCH NP
• Maxim Healthcare Services, Inc
• Jack Thomas McAfee, F.N.P.
• Cammie McCallister, CNA
• Michelle L McCreary, LPTA
• Regina M McDonough-Pyle, SPEECH PATHOLOGIST

• Physician Assistant in La Follette, TN
• Providers in La Follette, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.