Individual provider Active NPI

Renee Thompson Boston, PA

  • Medical Physician Assistant
  • Crossville, TN
National Provider Identifier
1982997714
Registry record updated Dec 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA3219 Issued in TN
Practice address
57 W Adams St
Crossville, TN 38555-4836
Phone
(931) 250-5433
Fax
(931) 250-5434
NPI assigned
May 26, 2011
Last updated
Dec 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA3219 TN Primary
Physical Therapist 225100000X PT6006 TN

Addresses

Primary practice location

57 W Adams St
Crossville, TN 38555-4836

Mailing address

88 Taylor Ave
Crossville, TN 38555-4532
Phone (931) 250-5433

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150128001165 TN Practitioner - Physical Therapist in Private Practice 9537483268 Reassigns benefits to 1 organization
I20170315001318 TN Practitioner - Physician Assistant 9537483268 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Synergy Medical Associates, PLLCGroup PAC ID 0547543019, 2 clinicians

Practice addresses (Care Compare)

57 W Adams St
Crossville, TN 38555-4836
Phone (931) 250-5433

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.72 of 100Reported as group
Quality
100
Promoting interoperability
86
Improvement activities
40
Cost
70.74

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PT6006TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Independent Physical Therapy, LLC Physical Therapist CurrentSince Jun 13, 2011 Accepting new patients
Independent Physical Therapy CurrentSince Jun 13, 2011 Accepting new patients

Locations

6397 Lee Hwy
Ste 300
Chattanooga, TN 37421
Phone (423) 238-8923

1202 N Charles G Seivers Blvd
Ste A
Clinton, TN 37716
Phone (865) 457-0192

820 Scenic Hwy
Ste B
Lookout Mtn, TN 37350
Phone (423) 825-1393

8823 Production Ln
Ooltewah, TN 37363
Phone (423) 238-8923

Interoperability endpoints

  • Direct secure messaging: renee.boston@39140016521220.direct.elationemr.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 2

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": "1306368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703808000000",
    "number": "1982997714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 TAYLOR AVE",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385554532",
            "telephone_number": "931-250-5433",
            "fax_number": "931-250-5434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 W ADAMS ST",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385554836",
            "telephone_number": "931-250-5433",
            "fax_number": "931-250-5434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSTON",
        "first_name": "RENEE",
        "middle_name": "THOMPSON",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-26",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TN",
            "license": "PA3219",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "PT6006",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crossville, TN

Sources for this page

Verify at the official NPI Registry.