JAMES C COUCH III M.D.
NPI 1376635052
Family Medicine in Mt Pleasant, TN

Q: What is James Couch's NPI number?

The NPI number for James Couch is 1376635052. It was assigned to this individual provider in the NPPES registry on September 29, 2006.

Q: What is James Couch's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for James Couch was last updated on October 4, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.

Active since September 29, 2006PECOS EnrolledAccepts Medicare Assignment

96.37/100

CMS Quality Rating

200 S CROSS BRIDGES RD, MT PLEASANT, TN 38474(931) 379-5821(931) 379-5867 Get Directions Write a Review

NPPES record last updated: October 4, 2010. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About James C Couch Iii M.d. NPPES

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

JAMES C COUCH III M.D. (NPI 1376635052) is an individual family medicine provider in Mt Pleasant, Tennessee, licensed in Tennessee (26082) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS, is affiliated with Williamson Medical Center, and is a graduate of East Tennessee State University Quillen College Of Medicine (1993).

NPPES Registry Identity

NPI1376635052

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameJAMES C COUCH IIICredential: M.D.

Location Address200 S CROSS BRIDGES RDMt Pleasant, TN 38474-1714

Mailing Address854 W James Campbell Blvd, Suite 303Columbia, TN 38401-4659 · (931) 540-4255 · Fax (931) 379-5867

Phone(931) 379-5821

Fax(931) 379-5867

Sole ProprietorNo

Medical School CMSEast Tennessee State University Quillen College Of MedicineGraduated 1993

Enumeration DateSeptember 29, 2006

Last NPPES UpdateOctober 4, 2010

✔ NPI 1376635052 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in TN · 26082

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

200 S CROSS BRIDGES RD, Mt Pleasant, TN 38474

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Other Identifiers 8

Other4022000TN · Bcbstn

Medicare PIN080177649TN

Medicaid3800692TN

Medicare PIN3710089

Medicaid3710089TN

Medicare UPING29461TN

Medicare PIN3800699

Medicare PINCE0561TN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of Tennessee, Oscar Insurance Company.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

James C Couch Iii M.d. 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 ID5597757153

PECOS Enrollment IDI20040401001588

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 19

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.

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309

A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.

877 services226 patients

Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308

A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.

314 services131 patients

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309

240 services138 patients

Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more 99306

An initial nursing facility visit is your first meeting with your healthcare team at a nursing facility. Lasting typically 45 minutes, this appointment involves a comprehensive health assessment and the creation of your personalized care plan. It's a crucial step to ensure your health and well-being.

231 services202 patients

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

167 services27 patients

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.

149 services76 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.

125 services71 patients

Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes 99305

An initial nursing facility visit per day is a service where a healthcare professional spends about 35 minutes assessing a patient's health status. This includes reviewing medical history, conducting a physical exam, and developing a care plan based on the patient's needs.

113 services98 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

72 services72 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

60 services37 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

57 services57 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

55 services55 patients

Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more 99306

46 services41 patients

Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308

36 services31 patients

Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes 99305

35 services33 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

29 services22 patients

Nursing facility discharge day management, 30 minutes or less 99315

Nursing facility discharge day management involves organizing your transition from the nursing facility to your home or another facility. This service, taking 30 minutes or less, includes finalizing medical instructions, arranging follow-up care, and answering any questions.

27 services26 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

17 services12 patients

Nursing facility discharge day management, 30 minutes or less 99315

11 services11 patients

Hospital Affiliations CMS Care Compare 2

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

Williamson Medical Center

Acute Care Hospitals · Franklin, TN

4/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number440029

Location4321 Carothers ParkwayFranklin, TN 37067 · Williamson County

Emergency services Birthing friendly

Maury Regional Hospital

Acute Care Hospitals · Columbia, TN

3/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number440073

Location1224 Trotwood AveColumbia, TN 38401 · Maury County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 38474 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.

96.37/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Individually scored

Quality

90.49

Promoting Interoperability

100

Improvement Activities

Cost

64.07

Reported Quality Measures

Advance Care Plan

77%146 patients4/55-star benchmark: 100%

Breast Cancer Screening

77%65 patients4/55-star benchmark: 93%

Closing the Referral Loop: Receipt of Specialist Report

67%66 patients4/55-star benchmark: 87%

Colorectal Cancer Screening

66%177 patients4/55-star benchmark: 88%

Controlling High Blood Pressure

81%163 patients4/55-star benchmark: 91%

Diabetes: Eye Exam

56%70 patients3/55-star benchmark: 100%

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

Lower rates are better for this measure.

10%70 patients4/55-star benchmark: 91%

Documentation of Current Medications in the Medical Record

99%906 patients4/55-star benchmark: 100%

e-Prescribing

99%775 patients4/55-star benchmark: 100%

HIV Screening

3%157 patients1/55-star benchmark: 60%

Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

28%373 patients2/55-star benchmark: 61%

Provide Patients Electronic Access to Their Health Information

84%219 patients4/55-star benchmark: 100%

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

78%154 patients4/55-star benchmark: 91%

Use of High-Risk Medications in Older Adults

Lower rates are better for this measure.

Patients appropriateDiagnosis: 3% · 134 patients

Patients totalRate: 32% · 152 patients

36%152 patients1/55-star benchmark: 100%

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.

Referred Medical Equipment & Supplies CMS DME claims 19

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

6 suppliers17 claims31 services$6.60 avg. paid by Medicare

Tape, non-waterproof, per 18 square inches A4450

DME-Medical/Surgical Supplies · category DA000N

1 supplier17 claims968 services$0.10 avg. paid by Medicare

For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe A5500

DME-Orthotic Devices · category DF000N

1 supplier15 claims30 services$61.00 avg. paid by Medicare

For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patient's foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (or higher), prefabricated, each A5512

DME-Orthotic Devices · category DF000N

1 supplier15 claims90 services$24.88 avg. paid by Medicare

Collagen based wound filler, dry form, sterile, per gram of collagen A6010

DME-Medical/Surgical Supplies · category DA023N

1 supplier30 claims703 services$29.93 avg. paid by Medicare

Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches A6199

DME-Medical/Surgical Supplies · category DA023N

1 supplier14 claims690 services$5.10 avg. paid by Medicare

Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing A6212

DME-Medical/Surgical Supplies · category DA023N

1 supplier25 claims285 services$9.36 avg. paid by Medicare

Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing A6219

DME-Medical/Surgical Supplies · category DA023N

1 supplier49 claims1,304 services$0.93 avg. paid by Medicare

Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing A6222

DME-Medical/Surgical Supplies · category DA023N

1 supplier32 claims696 services$2.06 avg. paid by Medicare

Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq. in. or less, each dressing A6231

DME-Medical/Surgical Supplies · category DA023N

1 supplier14 claims439 services$4.56 avg. paid by Medicare

Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard A6446

DME-Medical/Surgical Supplies · category DA023N

1 supplier22 claims2,709 services$0.38 avg. paid by Medicare

Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4035

Other-Enteral and Parenteral · category OB006N

2 suppliers14 claims364 services$5.76 avg. paid by Medicare

Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4150

Other-Enteral and Parenteral · category OB006N

1 supplier13 claims4,645 services$0.32 avg. paid by Medicare

Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260

DME-Hospital Beds · category DB000N

2 suppliers18 claims18 services$62.23 avg. paid by Medicare

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

2 suppliers11 claims11 services$29.32 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

3 suppliers24 claims24 services$71.90 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

2 suppliers19 claims19 services$32.91 avg. paid by Medicare

Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613

DME-Drugs Administered Through DME · category DG006N

4 suppliers16 claims1,991 services$0.03 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

1 supplier12 claims12 services$185.34 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 9

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

MARTHA KRISTIN WOODSIDE FNP-C

Nurse Practitioner