Individual provider Active NPI

Nan Vincelli, PA-C

  • Physician Assistant
  • Smyrna, TN
National Provider Identifier
1891013942
Registry record updated Feb 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1780 Issued in TN
Practice address
1332 Hazelwood Dr
Smyrna, TN 37167-3922
Phone
(615) 984-2850
NPI assigned
May 13, 2010
Last updated
Feb 10, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2017

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 1780 TN Primary

Addresses

Primary practice location

1332 Hazelwood Dr
Smyrna, TN 37167-3922

Mailing address

3026 Callaway Park PL
Thompsons Station, TN 37179-5467
Phone (615) 424-0758

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
I20150730011100 TN Practitioner - Physician Assistant 4284948647 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Current Care PAGroup PAC ID 9739260019, 545 clinicians

Practice addresses (Care Compare)

1332 Hazelwood Dr
Smyrna, TN 37167-3922
Phone (615) 267-2006

6413 Lee Hwy
Suite 107
Chattanooga, TN 37421-4860
Phone (423) 225-3358

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1780TNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care PA CurrentSince Dec 3, 2018 Accepting new patients
U.S. Healthworks Medical Group of Tennessee, PC CurrentSince Jul 1, 2017 Accepting new patients
American Current Care P.a. CurrentSince Dec 3, 2018 Accepting new patients

Locations

6413 Lee Hwy
Ste 107
Chattanooga, TN 37421
Phone (423) 225-3358

2510 Murfreesboro Pike
Nashville, TN 37217
Phone (615) 695-0095

2531 Elm Hill Pike
Nashville, TN 37214
Phone (615) 284-1843

339 White Bridge Pike
Nashville, TN 37209
Phone (615) 356-0770

1332 Hazelwood Dr
Smyrna, TN 37167
Phone (615) 267-2006

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

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.

NPI Registry JSON

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

{
    "created_epoch": "1273708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486684800000",
    "number": "1891013942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3026 CALLAWAY PARK PL",
            "city": "THOMPSONS STATION",
            "state": "TN",
            "postal_code": "371795467",
            "telephone_number": "615-424-0758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1332 HAZELWOOD DR",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371673922",
            "telephone_number": "615-984-2850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINCELLI",
        "first_name": "NAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-13",
        "last_updated": "2017-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "1780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smyrna, TN

Sources for this page

Verify at the official NPI Registry.