| 54 | 1 | POPLAR AVENUE CLINIC PLLC 1124588793, organization, Memphis | TN | 96 | $1.5M | - Adjudicated (sentenced, convicted) per a Department of Justice release dated January 8, 2026.
- Medicaid paid $1,519,438 in the last 12 observed months.
|
| 75 | 1 | SANJEEV KUMAR 1932381530, individual, Memphis | TN | 96 | $707K | - Adjudicated (sentenced, indicted, convicted) per a Department of Justice release dated February 28, 2025.
- Medicaid paid $707,185 in the last 12 observed months.
|
| 173 | 1 | TRENT CROSS 1053374454, individual, Oneida | TN | 95 | $61K | - Listed on the Medicare revocation list since September 19, 2017.
- Medicaid still paid claims in 8 later months, $60,816 in total.
|
| 189 | 1 | HARROGATE FAMILY & HEALTH CARE, INC. 1689831802, organization, Harrogate | TN | 95 | $51K | - Listed on the KY Medicaid exclusion list since June 5, 2020.
- Medicaid still paid claims in 8 later months, $51,396 in total.
|
| 207 | 1 | OTYLIA PRIMARY CARE, LLC 1437704079, organization, Memphis | TN | 95 | $37K | - Listed on the Medicare revocation list since December 6, 2022.
- Medicaid still paid claims in 21 later months, $36,734 in total.
|
| 215 | 1 | DAVID SINCAVAGE 1528036191, individual, Brentwood | TN | 95 | $33K | - Listed on the KY Medicaid exclusion list since February 7, 2017.
- Medicaid still paid claims in 2 later months, $33,294 in total.
|
| 269 | 1 | ALEXANDER ALPEROVICH 1922096221, individual, Jackson | TN | 94 | $12K | - Listed on the Medicare revocation list since May 20, 2021.
- Medicaid still paid claims in 20 later months, $12,483 in total.
|
| 357 | 1 | RAMON AQUINO 1508818311, individual, Clarksville | TN | 93 | $3K | - Listed on the Medicare revocation list since September 14, 2024.
- Medicaid still paid claims in 2 later months, $2,639 in total.
- Charged (charged) per a Department of Justice release dated June 23, 2026, not adjudicated.
- Medicaid paid $35,829 in the last 12 observed months.
|
| 381 | 1 | HORIZON CLINICIANS PLLC 1063978427, organization, Sevierville | TN | 93 | $1K | - Listed on the Medicare revocation list since May 1, 2023.
- Medicaid still paid claims in 2 later months, $1,418 in total.
|
| 386 | 1 | HARRISON YANG 1770505612, individual, Manchester | TN | 93 | $1K | - Listed on the Medicare revocation list since September 9, 2019.
- Medicaid still paid claims in 5 later months, $1,210 in total.
|
| 387 | 1 | ADVANCED CARDIOVASCULAR & VEIN CENTER 1164759189, organization, Jackson | TN | 93 | $1K | - Listed on the Medicare revocation list since May 20, 2021.
- Medicaid still paid claims in 5 later months, $1,200 in total.
|
| 473 | 1 | OAKLEY PHARMACY INC 1578856316, organization, Celina | TN | 90 | $0 | - Adjudicated (pleaded guilty, sentenced) per a Department of Justice release dated September 11, 2025.
- No Medicaid payments in the last 12 observed months.
|
| 484 | 1 | WHAT ABOUT US IN HOME HEALTH CARE 1548027030, organization, Memphis | TN | 90 | $0 | - Adjudicated (sentenced) per a Department of Justice release dated April 4, 2025.
- No Medicaid payments in the last 12 observed months.
|
| 498 | 1 | ADVANCED FOOT & ANKLE CARE OF MEMPHIS, LLC 1649471467, organization, Memphis | TN | 90 | $0 | - Adjudicated (convicted) per a Department of Justice release dated March 18, 2024.
- No Medicaid payments in the last 12 observed months.
|
| 519 | 1 | STEPHEN CIRELLI 1134120777, individual, Rogersville | TN | 90 | $0 | - Adjudicated (sentenced) per an HHS-OIG enforcement record dated May 9, 2024.
- No Medicaid payments in the last 12 observed months.
|
| 545 | 1 | EVANN HERRELL 1306850466, individual, Sevierville | TN | 90 | $0 | - Adjudicated (sentenced) per an HHS-OIG enforcement record dated May 9, 2024.
- No Medicaid payments in the last 12 observed months.
|
| 568 | 1 | NAKITA CANNADY 1194118760, individual, Bartlett | TN | 90 | $0 | - Adjudicated (sentenced) per a Department of Justice release dated April 4, 2025.
- No Medicaid payments in the last 12 observed months.
|
| 582 | 1 | ROCKY HILL PHARMACY, LLC 1518459866, organization, Knoxville | TN | 90 | $0 | - Adjudicated (indicted, convicted) per a Department of Justice release dated October 16, 2024.
- No Medicaid payments in the last 12 observed months.
|
| 589 | 1 | JOHN MANNING 1356311831, individual, Ashland City | TN | 90 | $0 | - Adjudicated (sentenced) per a Department of Justice release dated April 14, 2025.
- No Medicaid payments in the last 12 observed months.
|
| 604 | 1 | HELEN BOERMAN 1346375003, individual, Franklin | TN | 90 | $0 | - Adjudicated (pleaded guilty) per a Department of Justice release dated May 7, 2026.
- No Medicaid payments in the last 12 observed months.
|
| 626 | 1 | NATHAN LUCAS 1740247766, individual, Memphis | TN | 90 | $0 | - Adjudicated (sentenced, convicted) per a Department of Justice release dated March 18, 2024.
- No Medicaid payments in the last 12 observed months.
|
| 653 | 1 | HOLLI WOMACK 1538588439, individual, Knoxville | TN | 90 | $0 | - Adjudicated (sentenced) per a Department of Justice release dated July 8, 2024.
- No Medicaid payments in the last 12 observed months.
|
| 659 | 1 | CRESTAR LABS LLC 1114329521, organization, Spring Hill | TN | 90 | $0 | - Adjudicated (convicted, sentenced) per a Department of Justice release dated October 31, 2024.
- No Medicaid payments in the last 12 observed months.
|
| 681 | 1 | CYNTHIA CLEMONS 1689949794, individual, Knoxville | TN | 90 | $0 | - Adjudicated (sentenced) per a Department of Justice release dated July 8, 2024.
- No Medicaid payments in the last 12 observed months.
|
| 715 | 2 | NARICIA FUTRELL 1033425483, individual, Millington | TN | 83 | $893K | - Billed more hands-on hours than a day holds in 11 months, peaking at 33.0 hours per day across 3 billing organizations.
- 91% of Medicaid dollars are on codes with a history of abuse.
|
| 878 | 3 | XUHAN ZHANG 1497721518, individual, Nashville | TN | 68 | $4K | - Charged (indicted) per a Department of Justice release dated June 30, 2025, not adjudicated.
- Medicaid paid $4,213 in the last 12 observed months.
- Hours beyond a day in 6 months under one organization, which can be supervisory billing.
- Records needed.
- Medicaid dollars per patient on code 99356 ($154 per patient-month) sit in the top 5% of every provider billing that code.
- A second detector adds a weaker signal.
|
| 1316 | 3 | RANDE LAZAR 1841378403, individual, Memphis | TN | 65 | $141K | - Charged (indicted) per a state attorney general release dated March 19, 2025, not adjudicated.
- Medicaid paid $141,152 in the last 12 observed months.
|
| 1452 | 3 | GORDONSVILLE CLINIC 1033310206, organization, Gordonsville | TN | 65 | $34K | - Charged (indicted) per a Department of Justice release dated June 23, 2026, not adjudicated.
- Medicaid paid $34,123 in the last 12 observed months.
|
| 1453 | 3 | ANGELA MOSS 1457428195, individual, Gordonsville | TN | 65 | $34K | - Charged (indicted) per a Department of Justice release dated June 23, 2026, not adjudicated.
- Medicaid paid $34,123 in the last 12 observed months.
|
| 1560 | 3 | CLARKSVILLE HOME CARE SERVICES LLC 1427003607, organization, Clarksville | TN | 64 | $8K | - Part of provider network D1-00097, ranked 97 nationally.
|
| 1613 | 3 | PAIN INSTITUTE OF NASHVILLE, PLC 1073049102, organization, Clarksville | TN | 64 | $3K | - Charged (complaint) per a Department of Justice release dated September 11, 2024, not adjudicated.
- Medicaid paid $3,432 in the last 12 observed months.
|
| 1635 | 3 | AMEDISYS TENNESSEE, LLC 1114975539, organization, Memphis | TN | 63 | $2K | - Part of provider network D1-00090, ranked 90 nationally.
|
| 1816 | 3 | MURFREESBORO SNF HEALTHCARE LLC 1558198960, organization, Murfreesboro | TN | 60 | $0 | - Part of provider network D1-00075, ranked 75 nationally.
|
| 2047 | 3 | MGA HOME HEALTHCARE TENNESSEE, LLC 1851039978, organization, Memphis | TN | 60 | $0 | - Part of provider network D1-00084, ranked 84 nationally.
|
| 2162 | 3 | CLARKSVILLE HOME CARE SERVICES LLC 1033164298, organization, Clarksville | TN | 60 | $0 | - Part of provider network D1-00097, ranked 97 nationally.
|
| 2167 | 3 | CHURCH HILL TN OPCO LLC 1154907079, organization, Church Hill | TN | 60 | $0 | - Part of provider network D1-00087, ranked 87 nationally.
|
| 2253 | 3 | CAMPBELL COUNTY HMA LLC 1023099447, organization, LA Follette | TN | 60 | $0 | - Part of provider network D1-00097, ranked 97 nationally.
|
| 2388 | 3 | COVENANT LIVING AT SHANNONDALE 1396742334, organization, Maryville | TN | 60 | $0 | - Part of provider network D1-00075, ranked 75 nationally.
|
| 2534 | 3 | LEWIS COUNTY NURSING AND REHABILITATION CENTER LLC 1538124045, organization, Hohenwald | TN | 60 | $0 | - Part of provider network D1-00075, ranked 75 nationally.
|
| 2562 | 3 | DOVER CARE CENTER 1073225942, organization, Dover | TN | 60 | $0 | - Part of provider network D1-00059, ranked 59 nationally.
|
| 2809 | 3 | CENTERWELL HEALTH SERVICES USA, LLC 1215919899, organization, Cookeville | TN | 60 | $0 | - Part of provider network D1-00050, ranked 50 nationally.
|
| 2834 | 3 | ALEXIAN VILLAGE OF TENNESSEE 1730164583, organization, Signal Mountain | TN | 60 | $0 | - Part of provider network D1-00106, ranked 106 nationally.
|
| 2899 | 3 | NASHVILLE SNF HEALTHCARE LLC 1275360687, organization, Nashville | TN | 60 | $0 | - Part of provider network D1-00075, ranked 75 nationally.
|
| 2936 | 3 | HALL FAMILY PHARMACY INC 1053735217, organization, Jamestown | TN | 60 | $0 | - Charged (indicted) per a Department of Justice release dated December 20, 2024, not adjudicated.
|
| 3046 | 3 | ANDERSONVILLE TN OPCO, LLC 1083357628, organization, Andersonville | TN | 60 | $0 | - Part of provider network D1-00087, ranked 87 nationally.
|
| 3238 | 3 | CRESTVIEW HEALTH CARE AND REHABILITATION LLC 1972568749, organization, Brownsville | TN | 60 | $0 | - Part of provider network D1-00075, ranked 75 nationally.
|
| 3306 | 3 | MAJESTIC OPERATIONS LLC 1629508346, organization, Memphis | TN | 60 | $0 | - Part of provider network D1-00083, ranked 83 nationally.
|
| 3431 | 3 | GOODLETTSVILLE SNF HEALTHCARE LLC 1265269666, organization, Goodlettsville | TN | 60 | $0 | - Part of provider network D1-00075, ranked 75 nationally.
|
| 3522 | 3 | CLARKSVILLE PAIN INSTITUTE, LLC 1710395116, organization, Clarksville | TN | 60 | $0 | - Charged (complaint) per a Department of Justice release dated September 11, 2024, not adjudicated.
|
| 3525 | 3 | SMYRNA CARE CENTER 1790497667, organization, Smyrna | TN | 60 | $0 | - Part of provider network D1-00059, ranked 59 nationally.
|
| 3654 | 3 | SELMER SNF HEALTHCARE LLC 1629805049, organization, Selmer | TN | 60 | $0 | - Part of provider network D1-00075, ranked 75 nationally.
|
| 3656 | 3 | EMERALD SPRING HILL, INC. 1639625254, organization, Spring Hill | TN | 60 | $0 | - Part of provider network D1-00059, ranked 59 nationally.
|
| 3781 | 3 | MCKENZIE HEALTHCARE AND REHABILITATION CENTER LLC 1457316887, organization, MC Kenzie | TN | 60 | $0 | - Part of provider network D1-00075, ranked 75 nationally.
|
| 4062 | 3 | MT JULIET HEALTH CARE CENTER LLC 1508821752, organization, Mount Juliet | TN | 60 | $0 | - Part of provider network D1-00075, ranked 75 nationally.
|
| 4306 | 3 | CAMM CARE LLC 1487068136, organization, Oak Ridge | TN | 60 | $0 | - Charged (indicted) per a Department of Justice release dated June 27, 2024, not adjudicated.
|
| 4309 | 3 | WELLPARK HEALTHCARE CENTER, LLC 1528811130, organization, Knoxville | TN | 60 | $0 | - Part of provider network D1-00075, ranked 75 nationally.
|
| 4543 | 3 | BROOKHAVEN TN OPCO LLC 1104301837, organization, Kingsport | TN | 60 | $0 | - Part of provider network D1-00087, ranked 87 nationally.
|
| 4693 | 3 | COUNTRYSIDE TN REHAB LLC 1497447841, organization, Lawrenceburg | TN | 60 | $0 | - Part of provider network D1-00083, ranked 83 nationally.
|
| 4778 | 3 | CLARKSVILLE PAIN INSTITUTE, LLC 1669749537, organization, Clarksville | TN | 60 | $0 | - Charged (complaint) per a Department of Justice release dated September 11, 2024, not adjudicated.
|
| 4817 | 3 | EDNA ROBINSON 1427209337, individual, Memphis | TN | 60 | $0 | - Charged (arrested) per a state attorney general release dated October 8, 2024, not adjudicated.
|
| 4901 | 3 | ASERACARE HOSPICE - NEW HORIZONS, LLC 1750328134, organization, Murfreesboro | TN | 60 | $0 | - Part of provider network D1-00042, ranked 42 nationally.
|
| 5026 | 3 | OVERTON COUNTY HEALTH AND REHAB CENTER 1790786614, organization, Livingston | TN | 60 | $0 | - Part of provider network D1-00075, ranked 75 nationally.
|
| 5157 | 3 | SHALOM HOSPICE LLC 1023756285, organization, Brentwood | TN | 60 | $0 | - Part of provider network D1-00113, ranked 113 nationally.
|
| 5491 | 3 | COOKEVILLE SNF HEALTHCARE LLC 1497582894, organization, Cookeville | TN | 60 | $0 | - Part of provider network D1-00075, ranked 75 nationally.
|
| 5529 | 3 | ANTIOCH TN OPCO, LLC 1356133847, organization, Antioch | TN | 60 | $0 | - Part of provider network D1-00087, ranked 87 nationally.
|
| 5959 | 3 | LEXINGTON HEALTH CARE AND REHABILITATION LLC 1730144155, organization, Lexington | TN | 60 | $0 | - Part of provider network D1-00075, ranked 75 nationally.
|
| 6072 | 3 | NEWPORT TN OPCO LLC 1013651272, organization, Newport | TN | 60 | $0 | - Part of provider network D1-00087, ranked 87 nationally.
|
| 6116 | 3 | HUNTSVILLE TN OPCO LLC 1922583657, organization, Huntsville | TN | 60 | $0 | - Part of provider network D1-00087, ranked 87 nationally.
|
| 6125 | 3 | CLAIBORNE CARE CENTER 1255043121, organization, New Tazewell | TN | 60 | $0 | - Part of provider network D1-00059, ranked 59 nationally.
|
| 6482 | 3 | HEART N SOUL HOSPICE MEMPHIS 1699507434, organization, Memphis | TN | 60 | $0 | - Part of provider network D1-00090, ranked 90 nationally.
|
| 6676 | 3 | JELLICO TN OPCO LLC 1770049504, organization, Jellico | TN | 60 | $0 | - Part of provider network D1-00087, ranked 87 nationally.
|
| 6677 | 3 | CLAIBORNE MANAGEMENT LLC 1235528126, organization, Franklin | TN | 60 | $0 | - Part of provider network D1-00083, ranked 83 nationally.
|
| 6805 | 3 | PRESBYTERIAN HOMES OF TENNESSEE, INC. 1316944887, organization, Knoxville | TN | 60 | $0 | - Part of provider network D1-00075, ranked 75 nationally.
|
| 6954 | 3 | WAVERLY HEALTH CARE AND REHABILITATION CENTER, LLC 1730145822, organization, Waverly | TN | 60 | $0 | - Part of provider network D1-00075, ranked 75 nationally.
|
| 7130 | 3 | HEART AND SOUL HOSPICE LLC 1770184079, organization, Nashville | TN | 60 | $0 | - Part of provider network D1-00075, ranked 75 nationally.
|
| 7248 | 3 | SHALOM HOSPICE OF GREATER KNOXVILLE LLC 1689355620, organization, Knoxville | TN | 60 | $0 | - Part of provider network D1-00113, ranked 113 nationally.
|
| 7249 | 3 | CLARKSVILLE NURSING AND REHABILITATION CENTER LLC 1790740462, organization, Clarksville | TN | 60 | $0 | - Part of provider network D1-00075, ranked 75 nationally.
|
| 7335 | 4 | JOHN BARSOTTI 1942672209, individual, Knoxville | TN | 57 | $732K | - Hours beyond a day in 4 months, but with up to 234 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
- Medicaid dollars per patient on code 90837 ($449 per patient-month) sit in the top 5% of every provider billing that code.
- 76% of Medicaid dollars are on codes with a history of abuse.
|
| 7619 | 4 | ANNA TUKIVAKALA-HOLLY 1548534308, individual, Nashville | TN | 55 | $2.5M | - Hours beyond a day in 18 months, but with up to 502 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
- Medicaid dollars per patient on code 90791 ($231 per patient-month) sit in the top 5% of every provider billing that code.
|
| 7670 | 4 | JOSEPH RUPARD 1861451338, individual, Shelbyville | TN | 55 | $2.2M | - Hours beyond a day in 5 months, but with up to 1099 patients a month across 4 billing organizations, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
- Medicaid dollars per patient on code 99307 ($77 per patient-month) sit in the top 5% of every provider billing that code.
|
| 7734 | 4 | CHARLES JORDAN 1083784235, individual, Lebanon | TN | 55 | $1.6M | - Hours beyond a day in 2 months, but with up to 1300 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
- Medicaid dollars per patient on code 90460 ($54 per patient-month) sit in the top 5% of every provider billing that code.
|
| 7753 | 4 | IMRAN MIRZA 1679599922, individual, Memphis | TN | 55 | $1.4M | - Hours beyond a day in 21 months, but with up to 1272 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
- Medicaid dollars per patient on code 99231 ($124 per patient-month) sit in the top 5% of every provider billing that code.
|
| 7802 | 4 | JAN FINE 1336257583, individual, Knoxville | TN | 55 | $1.2M | - Hours beyond a day in 4 months under one organization, which can be supervisory billing.
- Records needed.
- Medicaid dollars per patient on code 92508 ($118 per patient-month) sit in the top 5% of every provider billing that code.
|
| 8172 | 4 | CYNTHIA HARMON 1992031363, individual, Knoxville | TN | 53 | $1.2M | - Hours beyond a day in 7 months, but with up to 480 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
- 61% of Medicaid dollars are on codes with a history of abuse.
|
| 8173 | 4 | TWANA MILLER 1912248212, individual, Jackson | TN | 53 | $1.2M | - Hours beyond a day in 25 months under one organization, which can be supervisory billing.
- Records needed.
- 85% of Medicaid dollars are on codes with a history of abuse.
|
| 8193 | 4 | DEBORAH DRIGGS 1104113943, individual, Murfreesboro | TN | 53 | $921K | - Hours beyond a day in 8 months under one organization, which can be supervisory billing.
- Records needed.
- 86% of Medicaid dollars are on codes with a history of abuse.
|
| 8230 | 4 | LAURA HUDDLESTON 1154417285, individual, Chattanooga | TN | 53 | $465K | - Hours beyond a day in 4 months, but with up to 563 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
- 64% of Medicaid dollars are on codes with a history of abuse.
|
| 8247 | 4 | RICHARD CURRAN 1285685073, individual, Nashville | TN | 53 | $357K | - Hours beyond a day in 1 month under one organization, which can be supervisory billing.
- Records needed.
- 82% of Medicaid dollars are on codes with a history of abuse.
|
| 8254 | 4 | TERRI PONDER 1679812895, individual, Tullahoma | TN | 52 | $284K | - Hours beyond a day in 2 months, but with up to 400 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
- 60% of Medicaid dollars are on codes with a history of abuse.
|
| 8320 | 4 | KIMBERLY MOATS 1770663080, individual, Knoxville | TN | 52 | $8.1M | - Hours beyond a day in 71 months, but with up to 837 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
|
| 8339 | 4 | ANDREA SONNABEND 1659409910, individual, Clarksville | TN | 52 | $7.0M | - Hours beyond a day in 59 months, but with up to 1357 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
|
| 8358 | 4 | ROBERT YOUNG 1245368380, individual, Madison | TN | 52 | $6.4M | - Hours beyond a day in 41 months, but with up to 948 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
|
| 8361 | 4 | CRYSTAL CRUMLEY 1235352360, individual, Cleveland | TN | 52 | $6.3M | - Hours beyond a day in 27 months, but with up to 1248 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
|
| 8384 | 4 | CHERYL SEVIGNY 1548332067, individual, Chattanoog | TN | 52 | $5.7M | - Hours beyond a day in 27 months, but with up to 837 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
|
| 8389 | 4 | ELIZABETH SAVAGE 1588940555, individual, Nashville | TN | 52 | $5.6M | - Hours beyond a day in 32 months, but with up to 748 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
|
| 8391 | 4 | CINDY COTHRAN 1639207087, individual, Shelbyville | TN | 52 | $5.5M | - Hours beyond a day in 43 months, but with up to 990 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
|
| 8395 | 4 | MELANIE DAUGHERTY 1952430571, individual, Clarksville | TN | 52 | $5.3M | - Hours beyond a day in 31 months, but with up to 723 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
|
| 8422 | 4 | ANN BLANKENSHIP 1801069380, individual, Shelbyville | TN | 52 | $4.7M | - Hours beyond a day in 29 months, but with up to 624 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
|
| 8435 | 4 | RICHARD YEE 1871949628, individual, Bartlett | TN | 52 | $4.4M | - Hours beyond a day in 23 months, but with up to 2130 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
|
| 8487 | 4 | DAVID FRANZ 1942398060, individual, Cleveland | TN | 52 | $3.6M | - Hours beyond a day in 53 months, but with up to 1508 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
|