THOMAS JORDAN HARTLINE (CRNP) – Nurse Practitioner, NPI 1902770613

THOMAS JORDAN HARTLINE (CRNP) is a healthcare provider. based in Rainsville, Alabama. specializing in NURSE PRACTITIONER. They hold the professional credentials CRNP. They hold a License No. 1-182090 (AL). The NPI Number for THOMAS JORDAN HARTLINE (CRNP) is 1902770613

Main info

Male
2 Years Of Experience
Accepts Medicare Assignment
Name
THOMAS JORDAN HARTLINE (CRNP)
NPI
1902770613
Phone
Not provided
Address
1288 KIRK RD
Enumeration Date
4 October 2025
Last Update Date
4 October 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2565938310
Graduation Year
2024 (2 years ago)
PAC ID
8426543810
Group Practice PAC ID
9537669718
Professional Enrollment ID
I20251223002133
Address ID
AL359575908BO2505X431X400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness85
Years active:0State licenses:1Digital endpointsOther names

5,653 NURSE PRACTITIONER in AL

Provider Addresses for THOMAS JORDAN HARTLINE (CRNP)

  • 1288 KIRK RD

    RAINSVILLE, AL 359866029

    Phone:

    Type: Mailing

  • 2505 US HIGHWAY 431

    BOAZ, AL 359575908

    Phone: (256) 593-8310

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-12-23

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20251223002133INurse PractitionerALTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 35986)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9537669718View full group profile
NameSpecialtyState
Emergency MedicineAL
Family PracticeAL
Nurse PractitionerAL
Family PracticeSC
Internal Medicine, Hospitalist, Internal MedicineVA
Internal Medicine, Family PracticeAL
Internal MedicineFL
Family PracticeAL
Internal MedicineMI
Family PracticeAL

Reviews

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Frequently asked questions

What is the 10-digit NPI for THOMAS JORDAN HARTLINE (CRNP)?
THOMAS JORDAN HARTLINE (CRNP) — NPI 1902770613 — is the standard way to identify this listing.
Can I rely on THOMAS JORDAN HARTLINE (CRNP) being an active provider?
As of the registry snapshot, THOMAS JORDAN HARTLINE (CRNP) is marked active.
What healthcare role does THOMAS JORDAN HARTLINE (CRNP) hold?
Scheduling teams often label THOMAS JORDAN HARTLINE (CRNP) under Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where is THOMAS JORDAN HARTLINE (CRNP) based?
THOMAS JORDAN HARTLINE (CRNP) is tied to Rainsville, Alabama in the data we show; additional addresses may exist on the full record.
Why does THOMAS JORDAN HARTLINE (CRNP) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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