Individual provider Active NPI

Thomas T Alleva, PA-C

  • Medical Physician Assistant
  • Jackson, TN
National Provider Identifier
1699122879
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
3030 Issued in TN
Practice address
620 Skyline Dr
Jackson, TN 38301-3923
Phone
(731) 541-5000
NPI assigned
May 18, 2016
Last updated
Jun 10, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 3030 TN Primary
Emergency Medicine Physician 207P00000X 3030 TN
Family Medicine Physician 207Q00000X 3030 TN
Internal Medicine Physician 207R00000X 3030 TN
Pediatrics Physician 208000000X 3030 TN
Physical Medicine & Rehabilitation Physician 208100000X 3030 TN
Diagnostic Radiology Physician 2085R0202X 3030 TN
Surgery Physician 208600000X 3030 TN

Addresses

Primary practice location

620 Skyline Dr
Jackson, TN 38301-3923

Mailing address

620 Skyline Dr
Jackson, TN 38301-3923
Phone (731) 541-5000

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
I20160810002204 TN Practitioner - Physician Assistant 5395039564 Reassigns benefits to 10 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lexington Clinic CorpGroup PAC ID 2466468558, 23 clinicians

Practice addresses (Care Compare)

200 W Church St
Lexington, TN 38351-2038
Phone (731) 968-3646

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3030TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shamrock Community Hospital Inc Emergency Medicine CurrentSince Oct 14, 2024 Accepting new patients
Lexington Hospital Corporation CurrentSince Mar 14, 2025 Accepting new patients
Fast Pace Medical Clinic PLLC Family Medicine CurrentSince Nov 1, 2017 Accepting new patients
Haywood County Community Hospital Inc CurrentSince Mar 14, 2025 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Nov 1, 2017 Accepting new patients
Lexington Clinic Corp Emergency Medicine CurrentSince Mar 14, 2025 Accepting new patients
Shamrock Community Hospital Inc. CurrentSince Oct 14, 2024 Accepting new patients
Lexington Hospital Corporation Past Accepting new patients
Lexington Hospital Corporation Past Accepting new patients
Lexington Hospital Corporation Emergency Medicine Past Accepting new patients

Locations

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

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

2718 Squirrel Hollow Dr
Linden, TN 37096
Phone (931) 587-2121

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/henders-823c208a

Organizations & group practices 17

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.

View all 17

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1463529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1699122879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 SKYLINE DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013923",
            "telephone_number": "731-541-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 SKYLINE DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013923",
            "telephone_number": "731-541-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEVA",
        "first_name": "THOMAS",
        "middle_name": "T",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-18",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TN",
            "license": "3030",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "3030",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "3030",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "3030",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "3030",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TN",
            "license": "3030",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TN",
            "license": "3030",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "3030",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.