DR. JOHN DAVID TULLOS (M.D.) – Sports Medicine (Orthopaedic Surgery) Physician, NPI 1104138908

DR. JOHN DAVID TULLOS (M.D.) is a healthcare provider. based in Dickson, Tennessee. specializing in SPORTS MEDICINE, ORTHOPEDIC SURGERY. They hold the professional credentials M.D.. They hold a License No. 54403 (TN). The NPI Number for DR. JOHN DAVID TULLOS (M.D.) is 1104138908

Main info

Male
16 Years Of Experience
Accepts Medicare Assignment
Name
DR. JOHN DAVID TULLOS (M.D.)
NPI
1104138908
Phone
(615) 446-5121
Address
127 CRESTVIEW PARK DR STE 209
Enumeration Date
8 July 2010
Last Update Date
17 March 2022

Doctor Profile

Medical School Name
UNIVERSITY OF MISSISSIPPI SCHOOL OF MEDICINE
Secondary Phone
9313633514
Graduation Year
2010 (16 years ago)
PAC ID
9739311812
Group Practice PAC ID
9436240017
Professional Enrollment ID
I20160810001291
Address ID
TN384784545PU1275XSTXX402
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience59
Completeness75
Years active:15State licenses:1Digital endpointsOther names

161 SPORTS MEDICINE in TN

Provider Addresses for DR. JOHN DAVID TULLOS (M.D.)

  • 127 CRESTVIEW PARK DR STE 209

    DICKSON, TN 370552856

    Phone: (615) 446-5121

    Fax: (615) 446-1359

    Type: Mailing

  • 127 CRESTVIEW PARK DR STE 204

    DICKSON, TN 370552856

    Phone: (615) 441-4545

    Fax: (615) 441-4505

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 5 Open Payments records for all available years, with a total value of $246.

Total Amount is formed as General ($246) + Research ($0) + Ownership ($0) = $246.

Last reported payment date: 2024-12-05 • Largest payer in this snapshot: Stryker Corporation ($133).

Total Amount

$246

General + Research + Ownership

Payments

5

Total payment records

General Amount

$246

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-05

Latest reported date

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: 2016-08-10

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
I20160810001291ISports MedicineTNTBD

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 37055)

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Provider's Procedures

DR. JOHN DAVID TULLOS (M.D.) performs procedures in SPORTS MEDICINE. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
ORTHOPEDIC SURGERYTN20610Aspiration and/or injection of large joint or joint capsule1414

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
-TN
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 do I look up DR. JOHN DAVID TULLOS (M.D.) by NPI?
Use NPI 1104138908 when you need to reference DR. JOHN DAVID TULLOS (M.D.) in forms, claims, or directories.
Is DR. JOHN DAVID TULLOS (M.D.) currently active in the NPI registry?
CMS-published data lists DR. JOHN DAVID TULLOS (M.D.) as an active registrant.
What kind of provider is DR. JOHN DAVID TULLOS (M.D.)?
The page reflects Sports Medicine (Orthopaedic Surgery) Physician for DR. JOHN DAVID TULLOS (M.D.). Clinical services aligned with this taxonomy classification.
Where is DR. JOHN DAVID TULLOS (M.D.)'s primary listing?
We display Dickson, Tennessee because that is what the record indicates for DR. JOHN DAVID TULLOS (M.D.).
What if Dickson, Tennessee seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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