Jerrod Anderson
Individual provider Active NPI Family Medicine Physician · Richmond Hill, GA
NPI 1013302587 · NPPES record last updated Sep 6, 2024
Key facts
- NPI
- 1013302587
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- E-10151 (AR)
- Practice address
- 3866 Belfast Keller Rd Ste 102
Richmond Hill, GA 31324-6865 - Phone
- (912) 819-9620
- Fax
- (912) 819-9621
- NPI assigned
- Apr 1, 2015
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 20
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- White River Health System, Inc.
SJC Medical Group Inc
Practice addresses (Care Compare)
1215 Sidney St
Suite 300
Batesville, AR 72501-7201
Phone (870) 793-1126
2200 Malcolm Ave
Newport, AR 72112-3668
2200 Malcolm Ave
Suite B
Newport, AR 72112-3697
Phone (870) 512-2500
3866 Belfast Keller Rd
Building One Suite 102
Richmond Hill, GA 31324-6863
Phone (912) 819-4949
Hospital & facility affiliations
- St Joseph'S/ Candler Home Healthcare
- Centerwell Home Health
- St Joseph'S Hospital - Savannah
- White River Medical Center
- Candler Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in AR, GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170221000594 | AR | Practitioner - Family Practice |
7618283805 | Reassigns benefits to 6 organizations |
| I20241023004386 | GA | Practitioner - Family Practice | 7618283805 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| White River Health System Inc | Current |
Accepting new patients | |
| White River Health System, Inc. | Family Medicine | Current |
Accepting new patients |
| White River Health System, Inc. | Family Medicine | Current |
Accepting new patients |
| White River Health System, Inc | Family Medicine | Current |
Accepting new patients |
| SJC Medical Group Inc | Family Medicine | Current |
Accepting new patients |
| White River Health System, Inc. | Current |
Accepting new patients | |
| White River Health System, Inc. | Current |
Accepting new patients | |
| White River Health System, Inc. | Family Medicine | Past | Accepting new patients |
Locations
1710 Harrison St
Batesville, AR 72501
Phone (870) 262-1240
3443 Harrison St
Batesville, AR 72501
Phone (870) 698-1635
1215 Sidney St
Ste 300
Batesville, AR 72501
Phone (870) 793-1126
16 Hospital Cir
Ste A
Batesville, AR 72501
Phone (870) 269-4361
409 Virginia Dr
#F
Batesville, AR 72501
Phone (870) 793-5356
1215 Sidney St
Ste 202
Batesville, AR 72501
Phone (870) 262-2000
1700 Harrison St
Ste N
Batesville, AR 72501
Phone (870) 262-2200
195 Hospital Dr
Ste B
Cherokee Vlg, AR 72529
Phone (870) 257-6000
521 Wilburn Rd
Heber Springs, AR 72543
Phone (501) 270-4200
1526 E Main St
Melbourne, AR 72556
Phone (870) 262-3210
105 Case Commons Dr
Mountain View, AR 72560
Phone (870) 269-4144
501 Vine St
Newark, AR 72562
Phone (870) 799-3299
2200 Malcolm Ave
Ste B
Newport, AR 72112
Phone (870) 512-2500
1217 Batesville Blvd
Southside, AR 72501
Phone (870) 262-2800
1217 Batesville Blvd
#F
Southside, AR 72501
Phone (870) 262-2800
3866 Belfast Keller Rd
Ste 102
Richmond Hill, GA 31324
Phone (912) 819-9620
11705 Mercy Blvd
Savannah, GA 31419
Phone (912) 819-2452
836 E 65th St
Ste 22
Savannah, GA 31405
Phone (912) 819-7878
Interoperability endpoints
- dranderj@direct.sjchs.org
- jerrod.anderson.1@13831.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | E-10151 | AR | Yes |
Addresses
Primary practice location
3866 Belfast Keller Rd Ste 102
Richmond Hill, GA 31324-6865
Mailing address
16 Hospital Cir Ste a
Batesville, AR 72501-7343
Phone (870) 262-5545
Other practice location 1
1710 Harrison St
Batesville, AR 72501-7303
Phone (870) 262-1200
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 218941001 | Medicaid | AR |
Other providers in Richmond Hill, GA
- Anna Marlene Ammons
- Holly E Amonett
- Amy Pearson, P.C.
- Delon Anderson-Cooksey
- Elisabeth Marie Anderson
- Brooke McGuire Andrews
- Amanda Andriski
- Cheri Andrulot
- Madchen Midori Arai
- Sherri Spires Armitage
All providers in Richmond Hill, GA · Family Medicine Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 6, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.