Individual provider Active NPI

Brandi Leanne Thoma

  • Family Nurse Practitioner
  • Decherd, TN
National Provider Identifier
1780204339
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
27351 Issued in TN
Practice address
2006 Decherd Blvd
Decherd, TN 37324-3818
Phone
(931) 967-7171
NPI assigned
Apr 23, 2020
Last updated
Jan 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 27351 TN Primary
Family Medicine Physician 207Q00000X 27351 TN

Addresses

Primary practice location

2006 Decherd Blvd
Decherd, TN 37324-3818

Mailing address

2006 Decherd Blvd
Decherd, TN 37324-3818
Phone (931) 967-7171

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
I20200527003139 TN Practitioner - Nurse Practitioner 6507287604 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Amg-Southern Tennessee LLCGroup PAC ID 5991765943, 54 clinicians

Practice addresses (Care Compare)

108 W Blackwell St
Tullahoma, TN 37388-3505
Phone (931) 841-3821

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27351TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Amg-Southern Tennessee LLC CurrentSince Nov 1, 2021 Accepting new patients
Amg-Southern Tennessee LLC CurrentSince Nov 1, 2021 Accepting new patients
Amg -Southern Tennessee LLC Past Accepting new patients

Locations

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

2006 Decherd Blvd
Decherd, TN 37324
Phone (931) 962-0561

108 W Blackwell St
Tullahoma, TN 37388
Phone (931) 841-3821

2118 Cowan Hwy
Winchester, TN 37398
Phone (931) 962-4040

83 Memorial Dr
Winchester, TN 37398
Phone (931) 967-3966

Interoperability endpoints

  • Direct secure messaging: brandi.thoma.1@19363.direct.athenahealth.com

Organizations & group practices 3

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": "1587600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1780204339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2006 DECHERD BLVD",
            "city": "DECHERD",
            "state": "TN",
            "postal_code": "373243818",
            "telephone_number": "931-967-7171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2006 DECHERD BLVD",
            "city": "DECHERD",
            "state": "TN",
            "postal_code": "373243818",
            "telephone_number": "931-967-7171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMA",
        "first_name": "BRANDI",
        "middle_name": "LEANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-23",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "27351",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "27351",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decherd, TN

Sources for this page

Verify at the official NPI Registry.