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James Tyler Irwin

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

2001 Laurel Ave # N304, Knoxville, TN 37916-1810

PECOS Enrollment

This provider is enrolled in PECOS as JAMES IRWIN.

Based on the most recent information from CMS, provider James Tyler Irwin is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1184269565
Provider Type
Individual
Full Name
Irwin, James Tyler
Credential
FNP-C

Gender
Male
Sole Proprietor
No
Enumeration Date
11/9/2019
Last Updated
5/8/2023

Contact Information

Practice Location

2001 Laurel Ave # N304, Knoxville, TN 37916-1810

(865) 595-4111

Unlisted Fax

Mailing Location

4286 Norris Fwy, Heiskell, TN 37754-3203

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 26824 Tennessee
Code 163W00000X	Description Registered Nurse Nursing Service Providers	License 194453 Tennessee

Provider Identifiers

ID	Description	Issuer
ID Q053715	Description Medicaid	Issuer Unlisted Tennessee

James Tyler Irwin

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Gardner, Aimee

Hull, Darrel T

Payne, Rachel

Yopp, Lisa B.

Archer, Tanya

Mcelmeel, Amanda

Blair, Candice Laura

Harrill, Kaitlyn Dorthea

Schleigh, Megan Chantel

Hermann, Erin Walker