William James Aderhold Jr., PA
Individual provider Active NPI Physician Assistant · Erwin, TN
NPI 1003975707 · NPPES record last updated Mar 7, 2023
Key facts
- NPI
- 1003975707
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 1667 (TN)
- Practice address
- 105 Gay St
Erwin, TN 37650 - Phone
- (423) 743-6141
- Fax
- (423) 743-1083
- NPI assigned
- Dec 8, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Unicoi Medical Associates | Past | Accepting new patients |
Interoperability endpoints
- https://api.platform.athenahealth.com/25094/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1667 | TN | Yes |
Addresses
Primary practice location
105 Gay St
Erwin, TN 37650
Mailing address
PO Box 399
Erwin, TN 37650-0399
Phone (423) 743-6141
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1510917 | Medicaid | TN | |
| 11914419 | Other | CAQH |
Other providers in Erwin, TN
- Joshua L Andrews
- Appalachian Emergency Physicians
- Associated Therapy Services of Unicoi County
- Allison Pate Athon
- Whitney Alison Babel
All providers in Erwin, TN · Physician Assistant in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.