NPIMap

Individual provider Active NPI

Ralph E Patterson, DO

  • Emergency Medicine Physician
  • Jackson, TN
National Provider Identifier
1720038557
Registry record updated Mar 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
1061 Issued in TN
Practice address
620 Skyline Dr
Jackson, TN 38301-3923
Phone
(730) 658-3100
NPI assigned
May 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2019

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 1239 WV
Family Medicine Physician 207Q00000X 34005153 OH
Hospitalist Physician 208M00000X 34.005153 OH
Hospitalist Physician 208M00000X 1061 TN
Emergency Medicine Physician 207P00000X 1061 TN Primary

Addresses

Primary practice location

620 Skyline Dr
Jackson, TN 38301-3923

Mailing address

620 Skyline Dr
Jackson, TN 38301-3923
Phone (731) 658-3100

Other identifiers 2

IdentifierTypeStateIssuer
0815470MedicaidOH
3810000704MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120618000382 TN Practitioner - Family PracticePractitioner - Emergency Medicine 8022912195 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
West Virginia School of Osteopathic Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Medical Care Facilities PCGroup PAC ID 6103837877, 57 clinicians

Practice addresses (Care Compare)

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

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34005153OHMDFamily Medicine Physician
34.005153OHMDHospitalist Physician
1061TNMDHospitalist Physician
1239WVMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Eagle Creek Emergency Group, PC Emergency Medicine CurrentSince Mar 25, 2019 Accepting new patients
Emergency Medical Care Facilities PC Emergency Medicine CurrentSince Nov 2, 2018 Accepting new patients
Lexington Hospital Corporation Past Accepting new patients
Northwest Ohio Urgent Care Inc Past Accepting new patients
Grant Memorial Hospital Past Accepting new patients
Lexington Clinic Corp Emergency Medicine Past Accepting new patients
Lexington Hospital Corporation Emergency Medicine Past Accepting new patients
Emergency Coverage, LLC Emergency Medicine Past Accepting new patients
Americare Health Services, LLC Past Accepting new patients
Hospitalist Medicine Physicians of Ohio, Professional Corporation Family Medicine Past Accepting new patients
Lexington Hospital Corporation Past Accepting new patients
Grant Memorial Hospital Past Accepting new patients
Emergency Coverage Services, PC Past Accepting new patients

Locations

650 Nuckolls Rd
Bolivar, TN 38008
Phone (731) 541-6834

175 Hospital Dr
Camden, TN 38320
Phone (731) 584-6135

620 Skyline Dr
Jackson, TN 38301
Phone (731) 541-4923

367 Hospital Blvd
Jackson, TN 38305
Phone (731) 661-2000

161 Mount Pelia Rd
Martin, TN 38237
Phone (731) 587-4261

4039 Highland St
Ste 1
Milan, TN 38358
Phone (731) 723-3668

301 Tyson Ave
Paris, TN 38242
Phone (731) 642-1220

Organizations & group practices 13

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 13

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": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552780800000",
    "number": "1720038557",
    "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": "731-658-3100"
        },
        {
            "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": "730-658-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "RALPH",
        "middle_name": "E",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2019-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "1239",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34005153",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OH",
            "license": "34.005153",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TN",
            "license": "1061",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "1061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0815470",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810000704",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.