Individual provider Active NPI

Algianon Moses Jeffero, MD

  • Emergency Medicine Physician
  • Dayton, TN
National Provider Identifier
1063458479
Registry record updated Nov 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
17448 Issued in TN
Practice address
9400 Rhea County Hwy
Dayton, TN 37321-7922
Phone
(423) 775-1121
Fax
(865) 291-3228
NPI assigned
Jun 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 17448 TN Primary

Addresses

Primary practice location

9400 Rhea County Hwy
Dayton, TN 37321-7922

Mailing address

PO Box 636019
Cincinnati, OH 45263-6019

Other identifiers 3

IdentifierTypeStateIssuer
3123825OtherTNBCBS OF TENNESSEE
3810597MedicaidTN
P00396558OtherTNRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20050728001029 TN Practitioner - Emergency Medicine 0244268506 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Meharry Medical College School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Emergency Physicians LLCGroup PAC ID 2466364997, 776 clinicians

Practice addresses (Care Compare)

304 Church St
Sweetwater, TN 37874-1181
Phone (865) 213-8200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Sweetwater Hospital ER Physician Group Emergency Medicine CurrentSince Jan 19, 1998 Accepting new patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Sep 1, 2022 Accepting new patients
Sweetwater Hospital Association CurrentSince Jan 19, 1998 Accepting new patients
Sweetwater Hospital Association Current Accepting new patients
Emergency Coverage, LLC Emergency Medicine Past Accepting new patients

Locations

9352 Park West Blvd
Knoxville, TN 37923
Phone (865) 373-1000

304 Church St
Sweetwater, TN 37874
Phone (865) 213-8200

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/sweet-8feb766f

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195171200000",
    "number": "1063458479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636019",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452636019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9400 RHEA COUNTY HWY",
            "city": "DAYTON",
            "state": "TN",
            "postal_code": "373217922",
            "telephone_number": "423-775-1121",
            "fax_number": "865-291-3228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFERO",
        "first_name": "ALGIANON",
        "middle_name": "MOSES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2007-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "17448",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TENNESSEE",
            "identifier": "3123825",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810597",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00396558",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, TN

Sources for this page

Verify at the official NPI Registry.