1. Home
  2. Directory
  3. Tennessee
  4. Monterey
  5. Nurse Practitioner
  6. NPI Profile

MICHAEL A RAWDON FNP MSN
NPI 1013904184
Nurse Practitioner - Family in Monterey, TN

Active since October 04, 2005PECOS EnrolledAccepts Medicare Assignment
400 W CRAWFORD AVE, MONTEREY, TN 38574(931) 839-2224(931) 839-2530 Get Directions Write a Review

NPPES record last updated: July 8, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 8, 2021, Jul 20, 2020, Dec 19, 2019 and 2 more (5 updates tracked since 2017).

About Michael A Rawdon Fnp Msn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MICHAEL A RAWDON FNP MSN (NPI 1013904184) is an individual family provider in Monterey, Tennessee, licensed in Tennessee (7888) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS, is affiliated with Cumberland Medical Center, and is a graduate of Vanderbilt University School Of Medicine (1999).

NPPES Registry Identity

NPI1013904184
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameMICHAEL A RAWDONCredential: FNP MSN
Location Address400 W CRAWFORD AVEMonterey, TN 38574-1166
Mailing Address400 W Crawford AveMonterey, TN 38574-1166 · (931) 839-2224 · Fax (931) 839-2530
Phone(931) 839-2224
Fax(931) 839-2530
Sole ProprietorNo
Medical School CMSVanderbilt University School Of MedicineGraduated 1999
Enumeration DateOctober 4, 2005
Last NPPES UpdateJuly 8, 20215 updates tracked since enumeration
NPPES CertifiedJuly 8, 2021
✔ NPI 1013904184 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in TN · 7888
400 W CRAWFORD AVE, Monterey, TN 38574
Open in Google Maps ↗

Other Identifiers 3

Other4267523TN · Bcbs
Medicaid7100155710KY
Medicaid3903854TN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Magnolia Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Michael A Rawdon Fnp Msn is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9739213018
PECOS Enrollment IDI20100823000794
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
409 services321 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
199 services199 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
91 services80 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
68 services57 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
19 services19 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Cumberland Medical Center

Acute Care Hospitals · Crossville, TN
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number440009
Location421 S Main StCrossville, TN 38555 · Cumberland County
Emergency services Birthing friendly

Cookeville Regional Medical Center

Acute Care Hospitals · Cookeville, TN
1/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number440059
Location1 Medical Center BoulevardCookeville, TN 38501 · Putnam County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 38574 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$81.53 typical visit price
range $52.64 – $160.89
Typical copayment $20.38 (range $13.16 – $40.22)
Most-billed visit code 99203
Established Patient
$93.60 typical visit price
range $16.72 – $131.41
Typical copayment $23.40 (range $4.18 – $32.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Adult Sinusitis: Computerized Tomography (CT) for Acute Sinusitis (Overuse)
Percentage of patients aged 18 years and older with a diagnosis of acute sinusitis who had a computerized tomography (CT) scan of the paranasal sinuses ordered at the time of diagnosis or received within 28 days after date of diagnosis
Lower rates are better for this measure.
0%62 patients
Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
38%332 patients2/55-star benchmark: 92%
Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
12%513 patients1/55-star benchmark: 100%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
45%611 patients3/55-star benchmark: 85%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
27%207 patients2/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%2,595 patients5/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
90%6,125 patients3/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
48%456 patients3/55-star benchmark: 88%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
98%247 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
33%1,271 patients2/55-star benchmark: 97%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
53%491 patients3/55-star benchmark: 90%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 100% · 679 patients
Patients tobacco: 13% · 100 patients
81%679 patients4/55-star benchmark: 98%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
85%1,271 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
13%1,271 patients1/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
18%1,271 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. CHARLES GRAY SMITH MD
Family Medicine
400 W CRAWFORD AVE
MONTEREY, TN 38574
Putnam County (931) 839-2224
MONTEREY MEDICAL LLC
Clinic/Center (Rural Health)
400 W CRAWFORD AVE
MONTEREY, TN 38574
Putnam County (931) 839-2224
STATE OF TENNESSEE
Clinic/Center (Federally Qualified Health Center (FQHC))
400 W CRAWFORD AVE
MONTEREY, TN 38574
Putnam County (315) 204-2039
MONTEREY DENTAL CENTER
Dentist
400 W CRAWFORD AVE, STE C
MONTEREY, TN 38574
Putnam County (931) 839-8684

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Michael Rawdon's NPI number?

The NPI number for Michael Rawdon is 1013904184. It was assigned to this individual provider in the NPPES registry on October 4, 2005.

Where is Michael Rawdon located?

Michael Rawdon practices at 400 W Crawford Ave, Monterey, TN 38574. The listed phone number is (931) 839-2224.

What is Michael Rawdon's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Michael Rawdon enrolled in Medicare?

Yes. Michael Rawdon is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Michael Rawdon accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Magnolia Health, Ambetter of Alabama and Ambetter of North Carolina and 3 other insurers list Michael Rawdon as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Michael Rawdon affiliated with any hospitals?

According to CMS data, Michael Rawdon is affiliated with Cumberland Medical Center and Cookeville Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Michael Rawdon was last updated on July 8, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.