Daniel Matthew Anderson, DO
Individual provider Active NPI Internal Medicine Physician · Powell, TN
NPI 1104112705 · NPPES record last updated Sep 1, 2020
Key facts
- NPI
- 1104112705
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 2996 (TN)
- Practice address
- 603 E Emory Rd Ste 105
Powell, TN 37849-3567 - Phone
- (865) 859-7377
- Fax
- (865) 859-7378
- NPI assigned
- Jun 22, 2011
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TN, KY
- 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 |
|---|---|---|---|---|
| I20160505000271 | TN | Practitioner - Internal Medicine | 9335448828 | Reassigns benefits to 1 organization |
| I20220430000192 | KY | Practitioner - Internal Medicine | 9335448828 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arh Mary Breckinridge Health Services, Inc. | Current |
Accepting new patients | |
| Arh Mary Breckinridge Health Services, Inc. | Current |
Accepting new patients | |
| Covenant Medical Group, Inc | Current |
Accepting new patients | |
| Covenant Medical Group, Inc. | Internal Medicine | Current |
Accepting new patients |
| Arh Mary Breckinridge Health Services, Inc. | Internal Medicine | Current | Accepting new patients |
Locations
80 Hospital Dr
Barbourville, KY 40906
Phone (606) 545-5500
100 Airport Gardens Rd
Ste 311
Hazard, KY 41701
Phone (606) 439-6978
Dept 888179
Knoxville, TN 37995
111 Clyde St
Loudon, TN 37774
Phone (865) 458-1554
1610 Tazewell Rd
Ste 201
Tazewell, TN 37879
Phone (423) 626-8393
Interoperability endpoints
- danielanderson@arh.medalliesdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 2996 | TN | Yes |
Addresses
Primary practice location
603 E Emory Rd Ste 105
Powell, TN 37849-3567
Mailing address
603 E Emory Rd Ste 105
Powell, TN 37849-3567
Phone (865) 859-7377
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Q020506 | Medicaid | TN |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | daniel.anderson.1@4694.direct.athenahealth.com |
Other providers in Powell, TN
- Robert C Alley
- Jessica L Allin
- Rene Alberto Alvarenga
- Omer Amari
- Tonya S. Ambler
- Melissa B Anderson
- Sarah Anderson
- Sean Anderson
- Richard Angelo Antonucci
- App of East Tennessee Ed PLLC
All providers in Powell, TN · Internal Medicine Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 1, 2020. 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).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.