Adelia Lee Birdwell, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5893 Issued in TN

Practice address

1407 W Baddour Pkwy
Lebanon, TN 37087-2513

Phone

(615) 444-6203

NPI assigned

Feb 13, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Spring Hill Dermatology PLCGroup PAC ID 4486755717, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Spring Hill Dermatology PLC

  • Dermatology Physician
  • Spring Hill, TN
  • NPI 1003028770
  Medicare reassignment Care Compare group
• Family Medical PC

  • Specialist
  • Lebanon, TN
  • NPI 1295805794
  Medicare reassignment
• Southeastern Dermatology Group PA

  • Dermatology Physician
  • Panama City, FL
  • NPI 1518972231

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1707782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1750145330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1407 W BADDOUR PKWY",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370872513",
            "telephone_number": "615-444-6203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1407 W BADDOUR PKWY",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370872513",
            "telephone_number": "615-444-6203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIRDWELL",
        "first_name": "ADELIA",
        "middle_name": "LEE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-13",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "5893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyler Karl Bennett, MAE, LAT, ATC
• Lauren Melissa Mourier Bentley, LCSW
• Sydney Victoria Berry, OD
• Best Care Services
• Irene Florence Bible, M.S.,CCC-SLP
• Vaibhav Singh Bisht
• Jason L Black, APRN-C
• Jennifer Rose Black
• Matthew Elisha Black
• Kristy M Blaney, RN, APRN

• Physician Assistant in Lebanon, TN
• Providers in Lebanon, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.