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CANONICO EAR, NOSE AND THROAT, P.C.
NPI 1932177805
Otolaryngology - Plastic Surgery within the Head & Neck in Tullahoma, TN

Active since March 08, 2006
507 NW ATLANTIC ST, TULLAHOMA, TN 37388(931) 393-4332(931) 393-2304 Get Directions Write a Review

NPPES record last updated: April 20, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Apr 20, 2021, Mar 2, 2016 (2 updates tracked since 2016).

About Canonico Ear, Nose And Throat, P.c. NPPES

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

CANONICO EAR, NOSE AND THROAT, P.C. (NPI 1932177805), doing business as Ear, Nose And Throat Associates Of Middle Tennessee, P.c., is a healthcare organization registered as a plastic surgery within the head & neck in Tullahoma, Tennessee and active in the NPI registry since March 2006. The organization lists Tandie L Moyers, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1932177805
Entity TypeOrganization
Primary Taxonomy207YX0007X
Legal Business NameCANONICO EAR, NOSE AND THROAT, P.C.
Location Address507 NW ATLANTIC STTullahoma, TN 37388-3504
Mailing Address507 Nw Atlantic StTullahoma, TN 37388-3504 · (931) 393-4332 · Fax (931) 393-2304
Phone(931) 393-4332
Fax(931) 393-2304
Organization SubpartNo
Authorized OfficialTandie L MoyersOffice Manager · (931) 684-3504
Enumeration DateMarch 8, 2006
Last NPPES UpdateApril 20, 20212 updates tracked since enumeration
NPPES CertifiedApril 20, 2021
✔ NPI 1932177805 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngology · Plastic Surgery within the Head & NeckAllopathic & Osteopathic Physicians
Taxonomy Code207YX0007X
Definition
An otolaryngologist with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgeries are practiced, there are many additional procedures which interface with them.
507 NW ATLANTIC ST, Tullahoma, TN 37388
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Other Names 1

Former Legal Business NameEar, Nose And Throat Associates Of Middle Tennessee, P.c.

Other Identifiers 3

Other3710667TN · Railroad Medicare
Other4064287TN · Bluecross Blueshield
Medicaid3710667TN

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 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)

Canonico Ear, Nose And Throat, P.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Canonico Ear, Nose And Throat, P.C., which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Robin Baker, AU.D.
Qualified Audiologist
NPI 1841268638
507 NW ATLANTIC ST
Tullahoma, TN 37388
(931) 393-4332
✔ Accepts MedicareSame address
Domenic Canonico, M.D.
Otolaryngology
NPI 1770551640
507 NW ATLANTIC ST
Tullahoma, TN 37388
(931) 393-4332
✔ 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.

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 Canonico Ear, Nose And Throat, P.C.'s NPI number?

The NPI number for Canonico Ear, Nose And Throat, P.C. is 1932177805. It was assigned to this organization in the NPPES registry on March 8, 2006. The provider was formerly known as Ear, Nose And Throat Associates Of Middle Tennessee, P.C..

Where is Canonico Ear, Nose And Throat, P.C. located?

Canonico Ear, Nose And Throat, P.C. is located at 507 NW Atlantic St, Tullahoma, TN 37388. The listed phone number is (931) 393-4332.

What is Canonico Ear, Nose And Throat, P.C.'s specialty?

The primary specialty registered for this NPI is Otolaryngology, specializing in Plastic Surgery within the Head & Neck, with taxonomy code 207YX0007X.

Is Canonico Ear, Nose And Throat, P.C. enrolled in Medicare?

Yes. Canonico Ear, Nose And Throat, P.C. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Canonico Ear, Nose And Throat, P.C.?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Canonico Ear, Nose And Throat, P.C., in Otolaryngology and Qualified Audiologist. 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. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Canonico Ear, Nose And Throat, P.C. was last updated on April 20, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.