DR. THOMAS MICHAEL HELTON MD
NPI 1881624450
Family Medicine in Murfreesboro, TN

Active since July 03, 2006PECOS EnrolledAccepts Medicare Assignment
1034 N HIGHLAND AVE, SUITE C, MURFREESBORO, TN 37130(615) 890-4810(615) 895-4391 Get Directions Write a Review

NPPES record last updated: April 13, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Thomas Michael Helton Md NPPES

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

DR. THOMAS MICHAEL HELTON MD (NPI 1881624450) is an individual family medicine provider in Murfreesboro, Tennessee, licensed in Tennessee (33960) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Saint Thomas Rutherford Hospital, and maintains a secondary practice location in Murfreesboro.

NPPES Registry Identity

NPI1881624450
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. THOMAS MICHAEL HELTONCredential: MD
Location Address1034 N HIGHLAND AVE, SUITE CMurfreesboro, TN 37130-2463
Mailing Address3024 Business Park Cir Ste CGoodlettsville, TN 37072-3132 · (615) 239-2018 · Fax (615) 895-4391
Fax(615) 895-4391
Sole ProprietorNo
Medical School CMSUniversity Of Tennessee, Hsc, College Of MedicineGraduated 1997
Enumeration DateJuly 3, 2006
Last NPPES UpdateApril 13, 2023
NPPES CertifiedApril 13, 2023
NPI 1881624450 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 · 33960
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.
1034 N HIGHLAND AVE, Murfreesboro, TN 37130

Secondary Practice Location 1

Location 11027 N Highland AveMurfreesboro, TN 37130-2450 · Phone (615) 895-2527

Accepted 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

Dr. Thomas Michael Helton Md 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 ID6608868526
PECOS Enrollment IDI20040331001576
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 22

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.
673 services349 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.
284 services31 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.
240 services240 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.
237 services47 patients
Injection, dexamethasone sodium phosphate, 1 mg J1100
Dexamethasone sodium phosphate is a medication given via injection. It is a type of steroid that helps reduce inflammation and immune responses. It can be used to treat a variety of conditions, such as allergies, skin conditions, arthritis, and more.
183 services21 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
160 services68 patients

Hospital Affiliations CMS Care Compare 2

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

Saint Thomas Rutherford Hospital

Acute Care Hospitals · Murfreesboro, TN
2/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number440053
Location1700 Medical Center ParkwayMurfreesboro, TN 37129 · Rutherford County
Emergency services Birthing friendly

Tristar Stonecrest Medical Center

Acute Care Hospitals · Smyrna, TN
3/5 CMS rating
OwnershipProprietary
CMS Certification Number440227
Location200 Stonecrest BoulevardSmyrna, TN 37167 · Rutherford County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37130 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

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
14%314 patients1/55-star benchmark: 96%
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…
63%601 patients3/55-star benchmark: 100%
Chronic Obstructive Pulmonary Disease (COPD): Spirometry Evaluation
Percentage of patients aged 18 years and older with a diagnosis of COPD who had spirometry results documented
1%87 patients1/55-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%2,402 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.
42%4,805 patients2/55-star benchmark: 100%
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…
14%36 patients1/55-star benchmark: 98%
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%309 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.
2%527 patients1/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
46%601 patients2/55-star benchmark: 95%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
44%1,206 patients2/55-star benchmark: 100%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
48%1,015 patients2/55-star benchmark: 100%
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
32%128 patients2/55-star benchmark: 100%
Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling
Percentage of patients aged 18 years and older who were screened for unhealthy alcohol use using a systematic screening method at least once within the last 24 months AND who received brief counseling if identified as an unhealthy alcohol user
77%886 patients4/55-star benchmark: 100%
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…
100%527 patients5/55-star benchmark: 100%
Screening for Osteoporosis for Women Aged 65-85 Years of Age
Percentage of female patients aged 65-85 years of age who ever had a central dual-energy X-ray absorptiometry (DXA) to check for osteoporosis
0%230 patients1/55-star benchmark: 97%
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…
93%527 patients5/55-star benchmark: 79%
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 10

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
17 suppliers45 claims143 services$5.22 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
3 suppliers14 claims14 services$20.15 avg. paid by Medicare
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) E0466
DME-Other DME · category DE005N
2 suppliers12 claims12 services$922.57 avg. paid by Medicare
High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each E0483
DME-Other DME · category DE000N
2 suppliers17 claims17 services$808.92 avg. paid by Medicare
Nebulizer, with compressor E0570
DME-Other DME · category DE000N
3 suppliers13 claims13 services$5.91 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
6 suppliers33 claims33 services$102.16 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 6

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

Podiatrist (Foot & Ankle Surgery)
1034 N HIGHLAND AVE, SUITE #B
MURFREESBORO, TN 37130
Family Medicine
1034 N HIGHLAND AVE, SUITE C
MURFREESBORO, TN 37130
Nurse Practitioner (Family)
1034 N HIGHLAND AVE
MURFREESBORO, TN 37130
Urology
1034 N HIGHLAND AVE, SUITE A
MURFREESBORO, TN 37130
Family Medicine
1034 N HIGHLAND AVE, SUITE C
MURFREESBORO, TN 37130
Nurse Practitioner (Family)
1034 N HIGHLAND AVE, SUITE C
MURFREESBORO, TN 37130

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 Helton's NPI number?

The NPI number for Thomas Helton is 1881624450. It was assigned to this individual provider in the NPPES registry on July 3, 2006.

Where is Thomas Helton located?

Thomas Helton practices at 1034 N Highland Ave Suite C, Murfreesboro, TN 37130. The listed phone number is (615) 890-4810.

What is Thomas Helton's specialty?

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

Is Thomas Helton enrolled in Medicare?

Yes. Thomas Helton 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 Helton 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 Thomas Helton 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 Helton affiliated with any hospitals?

According to CMS data, Thomas Helton is affiliated with Saint Thomas Rutherford Hospital and Tristar Stonecrest Medical Center.

When was this NPI record last updated?

The NPPES record for Thomas Helton was last updated on April 13, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.