Ronda K Pyles, PA-C

Individual provider Active NPI Physician Assistant · La Follette, TN

NPI 1689613705 · NPPES record last updated Oct 2, 2019

Key facts

NPI
1689613705
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
License
588 (TN)
Practice address
923 E Central Ave
La Follette, TN 37766-2768
Phone
(423) 907-1200
Fax
(865) 291-3228
NPI assigned
Jun 5, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 5

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.

Medicare Care Compare profile

Specialty
Physician Assistant
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DX Mso PLLC (88 clinicians)

Practice addresses (Care Compare)

5150 N Broadway St
Knoxville, TN 37918-2342
Phone (423) 458-1426

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20050809000934 TN Practitioner - Physician Assistant 8224067343 Reassigns benefits to 3 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
588TNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Afc Urgent Care and Family Care of WNC, PLLC Past Accepting new patients
Neighborhood Medical LLC Past
since Oct 6, 2019
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 588 TN Yes

Addresses

Primary practice location

923 E Central Ave
La Follette, TN 37766-2768

Mailing address

PO Box 787
Jacksboro, TN 37757-0787
Phone (423) 449-9079

Other identifiers

IdentifierTypeStateIssuer
4110213OtherTNBCBS

Other providers in La Follette, TN

All providers in La Follette, TN · Physician Assistant in Tennessee

Sources for this page

Verify at the official NPI Registry.