Individual provider Active NPI

Reece Nathaniel Rickertsen, DPM

  • Podiatrist
  • Gallatin, TN
National Provider Identifier
1790207496
Registry record updated Sep 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
0442 Issued in TN
Practice address
336 Sumner Hall Dr
Gallatin, TN 37066-3129
Phone
(615) 452-8899
NPI assigned
Jul 13, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X 0442 TN Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

336 Sumner Hall Dr
Gallatin, TN 37066-3129

Mailing address

336 Sumner Hall Dr
Gallatin, TN 37066-3129
Phone (615) 452-8899

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200910003464 TN Practitioner - Podiatry 5092089771 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Murfreesboro Medical Clinic, P.a.Group PAC ID 4789589227, 176 clinicians

Practice addresses (Care Compare)

1272 Garrison Dr
Murfreesboro, TN 37129-2598
Phone (615) 867-7925

Merit-based Incentive Payment System (MIPS)

Final score
87.82 of 100Reported as apm
Quality
79.78
Promoting interoperability
93.11
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue447
Removal or shaving of skin growth120
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0442TNMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Murfreesboro Medical Clinic, P.a. Multi-Specialty Current Accepting new patients

Locations

1272 Garrison Dr
Murfreesboro, TN 37129
Phone (615) 867-7925

Interoperability endpoints

  • Direct secure messaging: reecerickertsen@mmcsc.allscriptsdirect.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1499904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599523200000",
    "number": "1790207496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "336 SUMNER HALL DR",
            "city": "GALLATIN",
            "state": "TN",
            "postal_code": "370663129",
            "telephone_number": "615-452-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "336 SUMNER HALL DR",
            "city": "GALLATIN",
            "state": "TN",
            "postal_code": "370663129",
            "telephone_number": "615-452-8899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICKERTSEN",
        "first_name": "REECE",
        "middle_name": "NATHANIEL",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-13",
        "last_updated": "2020-09-08",
        "certification_date": "2020-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "TN",
            "license": "0442",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gallatin, TN

Sources for this page

Verify at the official NPI Registry.