MR. PRESTON PARKER EMBREY (PA) – Physician Assistant, NPI 1104059765

MR. PRESTON PARKER EMBREY (PA) is a healthcare provider. based in Dyersburg, Tennessee. specializing in Physician Assistant. They hold the professional credentials PA. They hold a License No. 1768 (TN). The NPI Number for MR. PRESTON PARKER EMBREY (PA) is 1104059765

Main info

Male
20 Years Of Experience
Accepts Medicare Assignment
Name
MR. PRESTON PARKER EMBREY (PA)
NPI
1104059765
Phone
(731) 286-4445
Address
1718 Parr Ave Ste C
Enumeration Date
31 August 2009
Last Update Date
9 July 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9317622332
Graduation Year
2006 (20 years ago)
PAC ID
1052451515
Group Practice PAC ID
9436240017
Professional Enrollment ID
I20091215000314
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience61
Completeness85
Years active:16State licenses:1Digital endpointsOther names

Provider Addresses for MR. PRESTON PARKER EMBREY (PA)

  • 1718 Parr Ave Ste C

    Dyersburg, TN 380242071

    Phone: (731) 286-4445

    Fax: (731) 286-4452

    Type: Location

  • 1718 PARR AVE STE C

    DYERSBURG, TN 380242071

    Phone: (731) 286-4445

    Fax: (731) 286-4452

    Type: Mailing

  • 257 BANCORP SOUTH PKWY # TN38305

    JACKSON, TN 383057582

    Phone: (731) 660-8759

    Fax: (731) 660-8739

    Type: Mailing

  • 270 E COURT AVE

    SELMER, TN 383752304

    Phone: (731) 541-9490

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $40.

Total Amount is formed as General ($40) + Research ($0) + Ownership ($0) = $40.

Last reported payment date: 2024-09-09 • Largest payer in this snapshot: ABIOMED ($40).

Total Amount

$40

General + Research + Ownership

Payments

1

Total payment records

General Amount

$40

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-09-09

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
ABIOMED$40
View all Open Payments →|Open Payments Risk Radar →

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: 2009-12-15

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
I20091215000314IPhysician AssistantTNTBD

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 38024)

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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: 9436240017View full group profile
NameSpecialtyState
Nurse PractitionerTN
Nurse PractitionerTN
General SurgeryTN
Nurse PractitionerTN
Sports Medicine, Orthopedic SurgeryTN
Nurse PractitionerTN
Family PracticeTN
Family PracticeTN
Nurse PractitionerTN
O B S T E T R I C S/ G Y N E C O L O G YNY

Reviews

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Frequently asked questions

How is MR. PRESTON PARKER EMBREY (PA) identified in CMS data?
CMS-hosted NPPES data lists MR. PRESTON PARKER EMBREY (PA) with NPI 1104059765.
Can I rely on MR. PRESTON PARKER EMBREY (PA) being an active provider?
As of the registry snapshot, MR. PRESTON PARKER EMBREY (PA) is marked active.
What is MR. PRESTON PARKER EMBREY (PA) best known for clinically?
Directory data describes MR. PRESTON PARKER EMBREY (PA) with Physician Assistant. Clinical services aligned with this taxonomy classification.
Does MR. PRESTON PARKER EMBREY (PA) list a practice location?
Patients near Dyersburg, Tennessee may find MR. PRESTON PARKER EMBREY (PA) in results; validate coverage separately.
Is the information about MR. PRESTON PARKER EMBREY (PA) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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