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THOMAS NELSON M.D.
NPI 1417901794
Family Medicine in Rutherford, TN

Active since May 20, 2006PECOS EnrolledAccepts Medicare Assignment
95.73/100
CMS Quality Rating
104 E MAIN ST, RUTHERFORD, TN 38369(731) 665-7741 Get Directions Write a Review

NPPES record last updated: July 12, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Thomas Nelson M.d. NPPES

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

THOMAS NELSON M.D. (NPI 1417901794) is an individual family medicine provider in Rutherford, Tennessee, licensed in Tennessee (29728) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with Jackson-madison County General Hospital, and is a graduate of University Of Cincinnati College Of Medicine (1979).

NPPES Registry Identity

NPI1417901794
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameTHOMAS NELSONCredential: M.D.
Location Address104 E MAIN STRutherford, TN 38369-9711
Mailing Address17 Quail RdgTrenton, TN 38382-4000 · (731) 855-4283
Phone(731) 665-7741
Sole ProprietorNo
Medical School CMSUniversity Of Cincinnati College Of MedicineGraduated 1979
Enumeration DateMay 20, 2006
Last NPPES UpdateJuly 12, 2024
NPPES CertifiedJuly 12, 2024
✔ NPI 1417901794 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 · 29728
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.
104 E MAIN ST, Rutherford, TN 38369
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Other Identifiers 6

Other4088427TN · Bcbs Provider Number
Other8081169TN · Cigna Healthcare Provider
Other157873TN · Unison Provider Number
Other32094TN · Tlc Provider Number
Medicaid3898024TN
Other7725301TN · Aetna Provider Number

Accepted Insurance

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

Thomas Nelson 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 ID1759360910
PECOS Enrollment IDI20040720000558
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 4

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 straightforward level of medical decision making, per day, if using time, at least 10 minutes 99307
A follow-up nursing facility visit per day typically lasts about 10 minutes. This service involves a healthcare professional checking on your health status, answering any questions you may have, and monitoring your progress. This routine check ensures your recovery is on track and any concerns are addressed promptly.
101 services25 patients
Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians a G0179
This procedure involves a doctor or approved practitioner reviewing your health status and re-certifying your need for Medicare-covered home health services. It includes communication with the home health agency and assessment of your health reports, even when you're not physically present.
60 services18 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.
19 services16 patients
Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180
This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.
16 services15 patients

Hospital Affiliations CMS Care Compare

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

Jackson-Madison County General Hospital

Acute Care Hospitals · Jackson, TN
3/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number440002
Location620 Skyline DriveJackson, TN 38301 · Madison County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 38369 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.

95.73/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality84.39
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 6

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

Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) A4314
DME-Orthotic Devices · category DF000N
1 supplier11 claims11 services$23.56 avg. paid by Medicare
Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each A4340
DME-Orthotic Devices · category DF000N
1 supplier13 claims13 services$30.71 avg. paid by Medicare
Insertion tray with drainage bag but without catheter A4354
DME-Medical/Surgical Supplies · category DA000N
1 supplier13 claims13 services$11.42 avg. paid by Medicare
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each A4357
DME-Orthotic Devices · category DF000N
1 supplier24 claims24 services$8.00 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
1 supplier15 claims15 services$17.64 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
1 supplier15 claims15 services$89.05 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 3

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

THOMAS H NELSON MD
Family Medicine
104 E MAIN ST
RUTHERFORD, TN 38369
Gibson County (731) 665-7741
RUSSELL E LITTLE APN
Nurse Practitioner (Family)
104 E MAIN ST
RUTHERFORD, TN 38369
Gibson County (731) 665-7741
THE RUTHERFORD MEDICAL CLINIC LLC
Nurse Practitioner (Family)
104 E MAIN ST
RUTHERFORD, TN 38369
Gibson County (731) 665-7741

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 Thomas Nelson's NPI number?

The NPI number for Thomas Nelson is 1417901794. It was assigned to this individual provider in the NPPES registry on May 20, 2006.

Where is Thomas Nelson located?

Thomas Nelson practices at 104 E Main St, Rutherford, TN 38369. The listed phone number is (731) 665-7741.

What is Thomas Nelson's specialty?

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

Is Thomas Nelson enrolled in Medicare?

Yes. Thomas Nelson 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 Thomas Nelson accept?

Health plans from BlueCross BlueShield of Tennessee list Thomas Nelson 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 Thomas Nelson affiliated with any hospitals?

According to CMS data, Thomas Nelson is affiliated with Jackson-Madison County General Hospital.

When was this NPI record last updated?

The NPPES record for Thomas Nelson was last updated on July 12, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.