Individual provider Active NPI

Willard F Gailbreath III, APN

  • Acute Care Nurse Practitioner
  • Lebanon, TN
National Provider Identifier
1932383676
Registry record updated Aug 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
13129 Issued in TN
Practice address
1420 W Baddour Pkwy Ste 100
Lebanon, TN 37087-1510
Phone
(615) 257-0190
Fax
(615) 470-8038
NPI assigned
Dec 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 13129 TN Primary

Addresses

Primary practice location

1420 W Baddour Pkwy Ste 100
Lebanon, TN 37087-1510

Mailing address

1420 W Baddour Pkwy Ste 100
Lebanon, TN 37087-1510
Phone (615) 257-0190

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
I20080407000048 TN Practitioner - Nurse Practitioner 4981781630 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anova Medical Associates, PLCGroup PAC ID 8325372741, 130 clinicians

Practice addresses (Care Compare)

1156 Nashville Pike
Gallatin, TN 37066-3110
Phone (615) 989-1088

Hospital & facility affiliations

  • Highpoint Health-Trousdale With Ascension Saint Hospital, Hartsville, TN, CCN 441301

Merit-based Incentive Payment System (MIPS)

Final score
90.67 of 100Reported as group
Quality
100
Improvement activities
40
Cost
61.39

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
13129TNMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Anova Medical Associates, PLC CurrentSince Jul 1, 2024 Accepting new patients
Tennessee Orthopedics, PC CurrentSince Dec 16, 2019 Accepting new patients
Tennessee Orthopedics, PC CurrentSince Dec 16, 2019 Accepting new patients

Locations

1156 Nashville Pike
Gallatin, TN 37066
Phone (615) 989-1088

1420 W Baddour Pkwy
Ste 100
Lebanon, TN 37087
Phone (615) 257-0190

1616 W Main St
Ste 300
Lebanon, TN 37087
Phone (615) 443-7374

1616 W Main St
Ste 203
Lebanon, TN 37087
Phone (615) 284-2000

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BAIBDD

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 and National Provider Directory roles.

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": "1197849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1932383676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 W BADDOUR PKWY STE 100",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370871510",
            "telephone_number": "615-257-0190",
            "fax_number": "615-470-8038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 W BADDOUR PKWY STE 100",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370871510",
            "telephone_number": "615-257-0190",
            "fax_number": "615-470-8038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAILBREATH",
        "first_name": "WILLARD",
        "middle_name": "F",
        "name_suffix": "III",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-17",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TN",
            "license": "13129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, TN

Sources for this page

Verify at the official NPI Registry.