Individual provider Active NPI

Alison Dawn Kucich, D.O.

  • Family Medicine Physician
  • Gallatin, TN
National Provider Identifier
1720029101
Registry record updated Jan 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1792 Issued in TN
Practice address
1483 Nashville Pike
Suite 302
Gallatin, TN 37066-7144
Phone
(615) 230-8601
Fax
(615) 230-9750
NPI assigned
Jun 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 1792 TN Primary

Addresses

Primary practice location

1483 Nashville Pike
Suite 302
Gallatin, TN 37066-7144

Mailing address

1483 Nashville Pike
Suite 302
Gallatin, TN 37066-7144
Phone (615) 230-8601

Other identifiers 2

IdentifierTypeStateIssuer
1513218MedicaidTN
P00724136OtherTNRAILROAD MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ALISON.KUCICH@hca1.eclinicaldirectplus.com

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070130000658 TN Practitioner - Family Practice 5698776821 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
New York College of Osteo Medicine of New York Institute of Technology, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Portland Primary Care, LLCGroup PAC ID 6305859851, 6 clinicians

Practice addresses (Care Compare)

1720 Nashville Pike
Suite 100
Gallatin, TN 37066-3154
Phone (615) 230-8601

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.28 of 100Reported as individual
Quality
100
Improvement activities
40
Cost
87.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Portland Primary Care LLC CurrentSince Jan 16, 2009 Accepting new patients
Portland Primary Care, LLC Family Medicine Past Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

1720 Nashville Pike
Ste 100
Gallatin, TN 37066
Phone (615) 230-8601

1483 Nashville Pike
Ste 302
Gallatin, TN 37066
Phone (615) 230-8601

355 New Shackle Island Rd
Hendersonvlle, TN 37075
Phone (615) 264-4000

103 Redbud Dr
Ste E
Portland, TN 37148
Phone (615) 325-1206

Interoperability endpoints

  • Direct secure messaging: alison.kucich@hca1.eclinicaldirectplus.com

Organizations & group practices 2

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.

Hospital & facility affiliations 6

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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643155200000",
    "number": "1720029101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1483 NASHVILLE PIKE",
            "address_2": "SUITE 302",
            "city": "GALLATIN",
            "state": "TN",
            "postal_code": "370667144",
            "telephone_number": "615-230-8601",
            "fax_number": "615-230-9750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1483 NASHVILLE PIKE",
            "address_2": "SUITE 302",
            "city": "GALLATIN",
            "state": "TN",
            "postal_code": "370667144",
            "telephone_number": "615-230-8601",
            "fax_number": "615-230-9750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUCICH",
        "first_name": "ALISON",
        "middle_name": "DAWN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2022-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "1792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1513218",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00724136",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ALISON.KUCICH@hca1.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "1483 Nashville Pike",
            "address_2": "SUITE 302",
            "city": "Gallatin",
            "state": "TN",
            "country_code": "US",
            "postal_code": "370667144",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gallatin, TN

Sources for this page

Verify at the official NPI Registry.