Individual provider Active NPI

Stephanie A Hull, PA

  • Physician Assistant
  • Cleveland, TN
National Provider Identifier
1801853635
Registry record updated Dec 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1346 Issued in TN
Practice address
2305 Chambliss Ave NW
Emergency Department
Cleveland, TN 37311-3847
Phone
(423) 559-6000
NPI assigned
Apr 26, 2006
Last updated
Dec 11, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1346 TN Primary

Addresses

Primary practice location

2305 Chambliss Ave NW
Emergency Department
Cleveland, TN 37311-3847

Mailing address

108 Holly TRL NW
Cleveland, TN 37311-1074
Phone (570) 847-4187

Other identifiers 1

IdentifierTypeStateIssuer
009978995MedicaidAL

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
I20060918000415 TN Practitioner - Physician Assistant 7214992072 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Preferred Surgical AssociatesGroup PAC ID 7517121460, 3 clinicians

Practice addresses (Care Compare)

1610 Tazewell Rd
Suite 301
Tazewell, TN 37879-3648
Phone (423) 626-4288

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Chattanooga Hamilton County Hospital Authority Past Accepting new patients
Chattanooga Hamilton County Hospital Authority Past Accepting new patients
Tennessee Em-I Medical Services, PC Past Accepting new patients
Tennessee Em-I Medical Services, PC Past Accepting new patients
Methodist Emergency Physicians PLLC Past Accepting new patients
Emergency Physicians PC Past Accepting new patients
Cherokee Emergency Services, Inc. Physician Assistant Past Accepting new patients

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228953600000",
    "number": "1801853635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 HOLLY TRL NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373111074",
            "telephone_number": "570-847-4187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2305 CHAMBLISS AVE NW",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373113847",
            "telephone_number": "423-559-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HULL",
        "first_name": "STEPHANIE",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-26",
        "last_updated": "2008-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "1346",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009978995",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, TN

Sources for this page

Verify at the official NPI Registry.