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TULLAHOMA DERMATOLOGY PC
NPI 1154948669
Dermatology in Tullahoma, TN

Active since June 30, 2020CLIA 44D2191972 · Certificate of Compliance
1330 CEDAR LN STE 700, TULLAHOMA, TN 37388(931) 455-7400 Get Directions Write a Review

NPPES record last updated: June 30, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Tullahoma Dermatology Pc NPPES

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

TULLAHOMA DERMATOLOGY PC (NPI 1154948669) is a healthcare organization registered as a dermatology in Tullahoma, Tennessee and active in the NPI registry since June 2020. The organization holds a CLIA Certificate of Compliance certificate valid through January 17, 2027 and lists Isaac Bryan, President, as its authorized official.

NPPES Registry Identity

NPI1154948669
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameTULLAHOMA DERMATOLOGY PC
Location Address1330 CEDAR LN STE 700Tullahoma, TN 37388-3276
Mailing Address1330 Cedar Ln Ste 700Tullahoma, TN 37388-3276
Phone(931) 455-7400
Organization SubpartNo
Authorized OfficialIsaac BryanPresident · (509) 426-4985
Enumeration DateJune 30, 2020
NPPES CertifiedJune 30, 2020
✔ NPI 1154948669 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
1330 CEDAR LN STE 700, Tullahoma, TN 37388
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tullahoma Dermatology Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Tullahoma Dermatology PC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Isaac Bryan, D.O.
Dermatology
NPI 1558708701
1330 CEDAR LN STE 700
Tullahoma, TN 37388
(931) 455-7400
✔ PECOS✔ Accepts MedicareSame address

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

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 Compliance 44D2191972

Tullahoma Dermatology, PC · Tullahoma, TN
Active · expires Jan 17, 2027
CLIA Number44D2191972
Laboratory TypePhysician Office
Certificate Effective DateJanuary 18, 2025
Certificate Expiration DateJanuary 17, 2027
Laboratory DirectorDr. Isaac G. Bryan
Laboratory Phone(931) 455-7400
Laboratory LocationTullahoma Dermatology, PC1330 Cedar Lane Ste 700, Tullahoma, TN 37388
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

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 Tullahoma Dermatology PC's NPI number?

The NPI number for Tullahoma Dermatology PC is 1154948669. It was assigned to this organization in the NPPES registry on June 30, 2020.

Where is Tullahoma Dermatology PC located?

Tullahoma Dermatology PC is located at 1330 Cedar Ln Ste 700, Tullahoma, TN 37388. The listed phone number is (931) 455-7400.

What is Tullahoma Dermatology PC's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Is Tullahoma Dermatology PC enrolled in Medicare?

Yes. Tullahoma Dermatology PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Tullahoma Dermatology PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dermatology) reassigns their Medicare billing to Tullahoma Dermatology PC. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Tullahoma Dermatology PC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 44D2191972) is associated with this NPI, valid through January 17, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Tullahoma Dermatology PC was last updated on June 30, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.