Individual provider Active NPI

Deon Tolliver, M.D.

  • Family Medicine Physician
  • Lebanon, TN
National Provider Identifier
1780096933
Registry record updated Dec 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
58523 Issued in KY
Practice address
217 E High St Ste 200
Lebanon, TN 37087-6709
Phone
(615) 227-3000
NPI assigned
May 22, 2014
Last updated
Dec 14, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 55364 TN
Family Medicine Physician 207Q00000X 58523 KY Primary

Addresses

Primary practice location

217 E High St Ste 200
Lebanon, TN 37087-6709

Mailing address

2711 Foster Ave
Nashville, TN 37210-5307
Phone (615) 620-8647

Other practice location 1

601 W Due West Ave
Madison, TN 37115-4423
Phone (615) 227-3000

Other practice location 2

3904 Gallatin Pike
Nashville, TN 37216-2406
Phone (615) 227-3000

Other practice location 3

1005 Dr. DB Todd Blvd
Nashville, TN 37208
Phone (615) 327-6322 ext. 6322

Other practice location 4

1000 S 12th St
Murray, KY 42071-9303
Phone (270) 854-1444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, KY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170912001976 TN Practitioner - Family Practice 7517230683 Reassigns benefits to 2 organizations
I20231115002281 KY Practitioner - Family Practice 7517230683 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1000 S 12TH St
Murray, KY 42071-9303
Phone (270) 854-1444

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
58523KYMDFamily Medicine Physician
55364TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
VMD Primary Providers Central Kentucky Family Medicine CurrentSince Oct 1, 2023 Accepting new patients
Meharry Medical College CurrentSince Sep 21, 2020 Accepting new patients
Primary Care Medical Center Inc Family Medicine Current Accepting new patients
Salient Health Association PLLC Family Medicine CurrentSince Jun 11, 2022 Accepting new patients
VMD Primary Providers Central Kentucky Family Medicine CurrentSince Oct 1, 2023 Accepting new patients

Locations

1000 S 12th St
Murray, KY 42071
Phone (270) 759-9200

403 Long Hollow Pike
Ste 201
Goodlettsvlle, TN 37072
Phone (615) 416-2175

1005 Dr Db Todd Jr Blvd
Nashville, TN 37208
Phone (615) 327-6000

Interoperability endpoints

  • Direct secure messaging: deon.tolliver.1@22064.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1400716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1780096933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2711 FOSTER AVE",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372105307",
            "telephone_number": "615-620-8647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 E HIGH ST STE 200",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370876709",
            "telephone_number": "615-227-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 W Due West Ave",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "TN",
            "postal_code": "371154423",
            "country_code": "US",
            "telephone_number": "615-227-3000",
            "fax_number": "615-515-5773",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3904 Gallatin Pike",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372162406",
            "country_code": "US",
            "telephone_number": "615-227-3000",
            "fax_number": "615-515-5773",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1005 Dr. DB Todd Blvd",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "37208",
            "country_code": "US",
            "telephone_number": "615-327-6322 x6322",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 S 12th St",
            "address_purpose": "LOCATION",
            "city": "Murray",
            "state": "KY",
            "postal_code": "420719303",
            "country_code": "US",
            "telephone_number": "270-854-1444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TOLLIVER",
        "first_name": "DEON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-22",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "55364",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "58523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, TN

Sources for this page

Verify at the official NPI Registry.