Ivy Lee Massengale, PA-C is a medicare enrolled "Physician Assistant" physician in La Follette, Tennessee. Her current practice location is
923 E Central Ave, La Follette, Tennessee. You can reach out to her office (for appointments etc.) via phone at
(423) 907-1200.
Ivy Lee Massengale is licensed to practice in * (Not Available) (license number ) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1689223489.
Physician's Profile
Full Name | Ivy Lee Massengale |
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Gender | Female |
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Speciality | Physician Assistant |
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Location | 923 E Central Ave, La Follette, Tennessee |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1689223489
- Provider Enumeration Date: 09/05/2019
- Last Update Date: 12/31/2019
Medicare PECOS Information:
- PECOS PAC ID: 7517393424
- Enrollment ID: I20200212000252
Medical Identifiers
Medical identifiers for Ivy Lee Massengale such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1689223489 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207P00000X | Emergency Medicine | 934 (Tennessee) | Secondary |
363A00000X | Physician Assistant | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ivy Lee Massengale is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Ivy Lee Massengale, PA-C 2305 Crystal Spring Ln, Hermitage, TN 37076-4196 Ph: (423) 637-2504 | Ivy Lee Massengale, PA-C 923 E Central Ave, La Follette, TN 37766-2768 Ph: (423) 907-1200 |
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