LAUREN ELIZABETH TISDALE (MD) – Dermatology Physician, NPI 1285258913
Dermatology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
293 DERMATOLOGY in TN
Provider Addresses for LAUREN ELIZABETH TISDALE (MD)
2885 BOONES CREEK RD
JOHNSON CITY, TN 376158002
Phone: (423) 928-9014
Type: Location
2300 W Stone Dr
Kingsport, TN 376602360
Phone: (423) 246-4961
Type: Location
PO BOX 980257
RICHMOND, VA 232980257
Phone: (804) 828-9783
Type: Mailing
VCUHS DEPT OF INTERNAL MEDICINE RESIDENCY, 980509
1250 E MARSHALL STREET
RICHMOND, VA 23298
Phone: (804) 828-8786
Type: Location
2300 W STONE DR
KINGSPORT, TN 376602360
Phone: (423) 246-4961
Fax: (423) 245-3136
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 7 Open Payments records for all available years, with a total value of $267.
Total Amount is formed as General ($267) + Research ($0) + Ownership ($0) = $267.
Last reported payment date: 2024-07-24 • Largest payer in this snapshot: SANOFI-AVENTIS U.S. LLC ($85).
Total Amount
$267
General + Research + Ownership
Payments
7
Total payment records
General Amount
$267
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-07-24
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2024-11-01
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20241101000654 | I | Dermatology | TN | TBD |
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.
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 37615)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| D E R M A T O L O G Y | TN | |
| D E R M A T O L O G Y | TN | |
| Nurse Practitioner | TN | |
| Nurse Practitioner | VA | |
| D E R M A T O L O G Y | TN | |
| - | TN | |
| D E R M A T O L O G Y | TN | |
| D E R M A T O L O G Y | TN | |
| Nurse Practitioner | TN | |
| D E R M A T O L O G Y | TN |
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