IVY LEE MASSENGALE (NPI# 1689223489) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689223489 |
| Entity Type | Individual |
| Full Name | IVY LEE MASSENGALE |
| Credential | PA-C |
| Practice Address |
923 E Central Ave La Follette TN 37766-2768 |
| Mailing Address |
2305 Crystal Spring Ln Hermitage TN 37076-4196 |
| Practice Telephone | 4239071200 |
| Mailing Telephone | 4236372504 |
| Enumeration Date | 2019-09-05 |
| Last Update Date | 2019-12-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | 934 | TN | Allopathic & Osteopathic Physicians |
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
923 E CENTRAL AVE |
| City | LA FOLLETTE |
| State | TN |
| Zip Code | 37766-2768 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548241953 | Campbell County Hma, LLC | Psychiatric Unit | 923 E Central Ave, La Follette, TN 37766-2768 | 2005-11-11 |
| 1194354092 | Greg Duane Edwards | Pharmacist | 923 E Central Ave, La Follette, TN 37766-2768 | 2020-04-03 |
| 1124657960 | Krista Jo Shouse | Pharmacist | 923 E Central Ave, La Follette, TN 37766-2768 | 2020-04-03 |
| 1841790177 | Lee Seargeant IIi | Pharmacist | 923 E Central Ave, La Follette, TN 37766-2768 | 2018-02-13 |
| 1457899882 | Tennessee Cancer Specialists, Pllc | Internal Medicine | 923 E Central Ave, La Follette, TN 37766-2768 | 2017-02-06 |
| 1427591999 | Douglas Roberts | Physical Therapist | 923 E Central Ave, La Follette, TN 37766-2768 | 2016-11-30 |
| 1851610356 | Kimberly Jean Rose | Physician Assistant | 923 E Central Ave, La Follette, TN 37766-2768 | 2010-05-24 |
| 1508196924 | Melissa Elaine Welden | Nurse Practitioner | 923 E Central Ave, La Follette, TN 37766-2768 | 2010-01-07 |
| 1245499581 | Roseann Michelle Basarich | Physical Therapist | 923 E Central Ave, La Follette, TN 37766-2768 | 2008-06-02 |
| 1891852125 | Thomas L Cohen | Specialist | 923 E Central Ave, Radiology Department, La Follette, TN 37766-2768 | 2007-01-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457819914 | Legal Medicine | Nurse Practitioner | 100 South 5th Street, Lafollette, TN 37766 | 2019-03-04 |
| 1306329818 | Kayla Ward | Nurse Practitioner | 617 E Central Ave, La Follette, TN 37766 | 2018-09-11 |
| 1740588920 | Campbell County Walk In Clinic LLC | Family Medicine | 2301 Jacksboro Pkie, Lafollette, TN 37766 | 2011-03-11 |
| 1992001853 | Complete Rural Healthcare and Medical Center Pllc | Specialist | 2146 Jacksboro Pike Suite C, Lafollette, TN 37766 | 2011-02-09 |
| 1821211582 | Bill R Fannon Jr. | Pharmacist | 502 West Central Ave, La Follette, TN 37766 | 2007-04-11 |
| 1437272606 | Kelly B Wells | Pharmacist | 502 West Central Avenue, La Follette, TN 37766 | 2007-04-10 |
| 1548386899 | Gerald A Troutman | Dentist | 109 East Beech Street, Lafollette, TN 37766 | 2007-03-21 |
| 1437280815 | Susan Rebecca Mills | Nurse Practitioner | 2221 Jacksboro Pike Ste C4, La Follette, TN 37766 | 2007-03-08 |
| 1699844399 | County of Campbell | Ambulance | 136 North Massachusetts Ave, Lafollette, TN 37766 | 2006-11-07 |
| 1336230465 | George O'neal Vinsant | Surgery | 919 E. Central Avenue, Suite 201, Lafollette, TN 37766 | 2006-09-27 |
| Find all providers in zip 37766 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598288425 | Mary Emily Tamer | Physician Assistant | 130 Independence Ln, La Follette, TN 37766-3073 | 2017-07-23 |
| 1861892424 | Alicia Noel Taylor | Physician Assistant | 2212 Jacksboro Pike, La Follette, TN 37766-2903 | 2014-09-01 |
| 1679848964 | Heather E. Grieve | Physician Assistant | 130 Independence Ln, La Follette, TN 37766-3073 | 2012-03-20 |
| 1144502477 | Campbell County Hma, LLC | Physician Assistant | 2145 Jacksboro Pike, La Follette, TN 37766-3003 | 2011-09-13 |
| 1851610356 | Kimberly Jean Rose | Physician Assistant | 923 E Central Ave, La Follette, TN 37766-2768 | 2010-05-24 |
| 1689613705 | Ronda K Pyles | Physician Assistant | 923 E Central Ave, La Follette, TN 37766-2768 | 2006-06-05 |
| 1578502696 | Kenneth Michael Sanders | Physician Assistant | 923 E Central Ave, La Follette, TN 37766-2768 | 2006-06-05 |
| 1437130408 | Teresa A Rasmussen | Physician Assistant | 130 Independence Ln, La Follette, TN 37766-3073 | 2005-11-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235737354 | Adrienne Smith | Physician Assistant | 5200 Park Ave Ste 100, Memphis, TN 38119-3505 | 2020-10-12 |
| 1417555459 | Kaitlyn Jones | Physician Assistant | 1229 Reserve Blvd Ste 200, Spring Hill, TN 37174-3274 | 2020-10-12 |
| 1861099491 | Caraline Berlynn Mcdowell | Physician Assistant | 284 Clearlake Dr W, Nashville, TN 37217-4547 | 2020-10-06 |
| 1508463365 | Logan Curran Martin | Physician Assistant | 5431 Edmondson Pike # 10, Nashville, TN 37211-5806 | 2020-10-05 |
| 1487261798 | Charity Grace Coppedge | Physician Assistant | 105 Twin Oaks Dr, Nashville, TN 37211-2765 | 2020-09-30 |
| 1316554884 | Brianna Bingham | Physician Assistant | 619 Blizzard Mines Rd, Harriman, TN 37748-3852 | 2020-09-28 |
| 1871100586 | Emily Philpott | Physician Assistant | 905 20th Ave S Apt 1306, Nashville, TN 37203-2672 | 2020-09-27 |
| 1063028876 | Emma Landers | Physician Assistant | 1534 Douglas Ave, Nashville, TN 37206-2309 | 2020-09-17 |
| 1730795527 | Melanie Rees | Physician Assistant | 111 33rd Ave S Apt 102, Nashville, TN 37212-3241 | 2020-09-17 |
| 1265048268 | Olivia Meers | Physician Assistant | 1080 Cedarview Ln, Franklin, TN 37067-4068 | 2020-09-16 |
| Find all providers with the same taxonomy | ||||
| City | LA FOLLETTE |
| Zip Code | 37766 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.