Samuel Tyler Anderson, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

70430 Issued in TN

Practice address

220 Fort Sanders West Blvd Ste 301
Knoxville, TN 37922-3398

Phone

(865) 690-3003

Fax

(865) 374-2143

NPI assigned

Mar 31, 2020

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Brody School of Medicine at East Carolina University, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Covenant Medical Group IncGroup PAC ID 2860305463, 363 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Parkwest Medical Center Hospital, Knoxville, TN, CCN 440173
• Fort Loudoun Medical Center Hospital, Lenoir City, TN, CCN 440110
• Cumberland Medical Center Hospital, Crossville, TN, CCN 440009

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• MS PPO
• MS PPO D-SNP
• KY PPO
• MS PPO C-SNP
• KY PPO C-SNP

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Covenant Medical Group, Inc.

  • Family Medicine Physician
  • Knoxville, TN
  • NPI 1457302010

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Covenant Medical Group, Inc

  • Durable Medical Equipment & Medical Supplies
  • Knoxville, TN
  • NPI 1871269415
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Cumberland Medical Center, Inc.

  • General Acute Care Hospital
  • Crossville, TN
  • NPI 1871596403
  Care Compare affiliation
• Fort Loudoun Medical Center

  • General Acute Care Hospital
  • Lenoir City, TN
  • NPI 1609860659
  Care Compare affiliation
• Parkwest Medical Center

  • General Acute Care Hospital
  • Knoxville, TN
  • NPI 1396739165
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1585612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1013545367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9330 PARK WEST BLVD STE 402",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234312",
            "telephone_number": "865-690-3003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 FORT SANDERS WEST BLVD STE 301",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379223398",
            "telephone_number": "865-690-3003",
            "fax_number": "865-374-2143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "SAMUEL",
        "middle_name": "TYLER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-31",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "70430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q091640",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "anderson.samuel.tyler@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "9330 Park West Blvd Ste 402",
            "city": "Knoxville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "379234312",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Melanie Dawson Anderson, RN
• Morgan Anderson, PA-C
• Nicholas Gray Anderson, M.D.
• Rebecca R Anderson, PT
• Sadie Brooke Anderson
• Sarah Kinsey Anderson, PT, DPT
• Sarah Lindsey Anderson, LCSW
• Stacy Amanda Anderson, MS CCCSLP
• Susanna Varlan Anderson, CNM
• Taiylor Anderson, RBT

• Internal Medicine Physician in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Internal Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.