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WEST TENNESSEE MEDICAL GROUP INC
NPI 1053615955
Internal Medicine in Jackson, TN

Active since January 06, 2011CLIA Certified · 2 labs
620 SKYLINE DR, JACKSON, TN 38301(731) 660-8730(731) 660-8739 Get Directions Write a Review

NPPES record last updated: October 30, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About West Tennessee Medical Group Inc NPPES

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

WEST TENNESSEE MEDICAL GROUP INC (NPI 1053615955) is a healthcare organization registered as an internal medicine in Jackson, Tennessee and active in the NPI registry since January 2011. The organization holds 2 active CLIA laboratory certificates and lists Bartley Teague, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1053615955
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameWEST TENNESSEE MEDICAL GROUP INC
Location Address620 SKYLINE DRJackson, TN 38301-3923
Mailing Address257 Bancorp South PkwyJackson, TN 38305-7582 · (731) 660-8730
Phone(731) 660-8730
Fax(731) 660-8739
Organization SubpartNo
Authorized OfficialBartley TeagueExecutive Director · (731) 512-1277
Enumeration DateJanuary 6, 2011
Last NPPES UpdateOctober 30, 2025
NPPES CertifiedOctober 30, 2025
✔ NPI 1053615955 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 11

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedNeurological SurgeryTaxonomy 207T00000X
Also ListedObstetrics & GynecologyTaxonomy 207V00000X
Also ListedPediatricsTaxonomy 208000000X
Also ListedPhysical Medicine & RehabilitationTaxonomy 208100000X
Also ListedPsychiatry & Neurology · NeurologyTaxonomy 2084N0400X
Also ListedPsychiatry & Neurology · Sleep MedicineTaxonomy 2084S0012X
Also ListedSurgery · Trauma SurgeryTaxonomy 2086S0127X
Also ListedThoracic Surgery (Cardiothoracic Vascular Surgery)Taxonomy 208G00000X
Also ListedHospitalistTaxonomy 208M00000X
620 SKYLINE DR, Jackson, TN 38301
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

West Tennessee Medical Group Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

242

Medicare enrollment records show 242 clinicians reassign Medicare billing to West Tennessee Medical Group Inc, which bills Medicare for the services they deliver. Of these, 12 practice at this address and 99 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 25

Nurse Practitioner66
Family Practice26
General Surgery26
Urology18
Gastroenterology16
Pulmonary Disease15
Neurology13
Vascular Surgery13
17 other specialties49

Nearest to this location (20)

See all 242
Ali Abualhayjaa, MD
Neurology
NPI 1134791197
620 SKYLINE DR
Jackson, TN 38301
(731) 541-5000
✔ PECOS✔ Accepts MedicareSame address
Monico Banez, MD
Internal Medicine
NPI 1962479451
620 SKYLINE DR
Jackson, TN 38301
(731) 660-8759
✔ PECOS✔ Accepts MedicareSame address
Gregory Barrett, MD
General Surgery
NPI 1487115119
620 SKYLINE DR
Jackson, TN 38301
(731) 541-5000
✔ PECOS✔ Accepts MedicareSame address
Shaniece Craft
General Surgery
NPI 1215592498
620 SKYLINE DR
Jackson, TN 38301
(731) 541-5000
✔ PECOS✔ Accepts MedicareSame address
Anastasios Georgious, M.D.
Radiation Oncology
NPI 1972603785
620 SKYLINE DR RADIATION ONCOLOGY DEPT
Jackson, TN 38301
(731) 541-6250
✔ PECOS✔ Accepts MedicareSame address
Ashley Hardee, NP
Nurse Practitioner
NPI 1407387509
620 SKYLINE DR
Jackson, TN 38301
(901) 651-6764
✔ PECOS✔ Accepts MedicareSame address
Sara Hodge
Nurse Practitioner
NPI 1982210282
620 SKYLINE DR
Jackson, TN 38301
(731) 541-5000
✔ PECOS✔ Accepts MedicareSame address
Edward Koonce, M.D.
Hospice/Palliative Care
NPI 1720067283
620 SKYLINE DR
Jackson, TN 38301
(731) 541-5000
✔ PECOSSame address
Ankita Krishnan, MBBS
Pulmonary Disease
NPI 1508356288
620 SKYLINE DR
Jackson, TN 38301
(731) 845-6329
✔ PECOS✔ Accepts MedicareSame address
Rebecca Morris, NP-C
Nurse Practitioner
NPI 1649799263
620 SKYLINE DR
Jackson, TN 38301
(731) 541-5000
✔ PECOS✔ Accepts MedicareSame address
Adrian Sarli, MD
General Surgery
NPI 1134744568
620 SKYLINE DR
Jackson, TN 38301
(731) 541-5000
✔ PECOS✔ Accepts MedicareSame address
Traci Walker, APRN
Nurse Practitioner
NPI 1518490960
620 SKYLINE DR
Jackson, TN 38301
(731) 541-5000
✔ PECOS✔ Accepts MedicareSame address
Kelly Blair, PH.D
Clinical Psychologist
NPI 1891711131
708 W FOREST AVE
Jackson, TN 38301
(731) 425-4930
✔ PECOS✔ Accepts Medicare0.1 mi
Thomas Norsworthy, M.D.
Family Practice
NPI 1790764223
708 W FOREST AVE
Jackson, TN 38301
(731) 425-6280
✔ PECOS0.1 mi
Bethany Lawrence, MD
Hospice/Palliative Care
NPI 1801823109
294 SUMMAR DR
Jackson, TN 38301
(731) 423-1932
✔ PECOS✔ Accepts Medicare0.1 mi
Natasha Austin, FNP
Nurse Practitioner
NPI 1881331387
620 SKYLINE DR
Jackson, TN 38301
(731) 422-0213
✔ PECOS✔ Accepts Medicare0.1 mi
Jeffrey Gillis, DO
Gastroenterology
NPI 1508125626
27A MEDICAL CENTER DR
Jackson, TN 38301
(731) 541-8300
✔ PECOS✔ Accepts Medicare0.1 mi
Melissa Appleton, MD
Emergency Medicine
NPI 1144287053
700 W FOREST AVE STE 300
Jackson, TN 38301
(731) 422-0330
✔ PECOS✔ Accepts Medicare0.1 mi
Douglas Taylor, MD
Neurosurgery
NPI 1578983797
700 W FOREST AVE STE 200
Jackson, TN 38301
(731) 541-9490
✔ PECOS✔ Accepts Medicare0.1 mi
Mojahid Ali, MD
Vascular Surgery
NPI 1821627910
700 W FOREST AVE FL 4
Jackson, TN 38301
(731) 541-2250
✔ PECOS✔ Accepts Medicare0.2 mi
See all 242 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 44D2307983

West Tennessee Medical Group Dba Wtmg Urology Jackson · Jackson, TN
Active · expires Jul 17, 2028
CLIA Number44D2307983
Laboratory TypePhysician Office
Certificate Effective DateJuly 18, 2026
Certificate Expiration DateJuly 17, 2028
Laboratory DirectorJosh Roberts
Laboratory Phone(731) 644-8582
Laboratory LocationWest Tennessee Medical Group Dba Wtmg Urology Jackson700 W Forest Ave, Jackson, TN 38301
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 44D1035519

Wt Medical Associates Dba West Tennessee Medical Group Endocrinology Dyersburg · Jackson, TN
Active · expires Jan 4, 2027
CLIA Number44D1035519
Laboratory TypePhysician Office
Certificate Effective DateJanuary 5, 2025
Certificate Expiration DateJanuary 4, 2027
Laboratory DirectorDr. Rauf M. Baba
Laboratory Phone(731) 660-6395
Laboratory LocationWt Medical Associates Dba West Tennessee Medical Group Endocrinology Dyersburg72 Physicians Drive, Jackson, TN 38305
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

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 West Tennessee Medical Group Inc's NPI number?

The NPI number for West Tennessee Medical Group Inc is 1053615955. It was assigned to this organization in the NPPES registry on January 6, 2011.

Where is West Tennessee Medical Group Inc located?

West Tennessee Medical Group Inc is located at 620 Skyline Dr, Jackson, TN 38301. The listed phone number is (731) 660-8730.

What is West Tennessee Medical Group Inc's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is West Tennessee Medical Group Inc enrolled in Medicare?

Yes. West Tennessee Medical Group Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through West Tennessee Medical Group Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 242 clinicians in 25 Medicare specialties reassign their Medicare billing to West Tennessee Medical Group Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (66), Family Practice (26) and General Surgery (26). Of these, 12 practice at this address and 99 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does West Tennessee Medical Group Inc hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does West Tennessee Medical Group Inc accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee and 1 other insurer list West Tennessee Medical Group Inc 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.

When was this NPI record last updated?

The NPPES record for West Tennessee Medical Group Inc was last updated on October 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months 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.