Individual provider Active NPI

Edward M McIntire Jr., M.D.

  • Urology Physician
  • Cleveland, TN
National Provider Identifier
1184689788
Registry record updated Mar 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
MD28981 Issued in TN
Practice address
400 Berywood TRL NW
Suite B
Cleveland, TN 37312-5287
Phone
(423) 472-3201
Fax
(423) 476-4949
NPI assigned
Apr 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X MD28981 TN Primary

Addresses

Primary practice location

400 Berywood TRL NW
Suite B
Cleveland, TN 37312-5287

Mailing address

400 Berywood TRL NW
Suite B
Cleveland, TN 37312-5287
Phone (423) 472-3201

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
I20100927001393 TN Practitioner - Urology 6608992664 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Arkansas College of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tennessee Valley Urology Center PCGroup PAC ID 2062538077, 6 clinicians

Practice addresses (Care Compare)

400 Berywood Nwtrl B
Cleveland, TN 37312-5288
Phone (423) 472-3201

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tennessee Valley Urology Center PC Urology CurrentSince Jul 21, 1997 Accepting new patients

Locations

719 Cook Dr
Ste 114
Athens, TN 37303
Phone (423) 745-8708

400 Berywood Trl NW
Ste B
Cleveland, TN 37312
Phone (423) 472-3201

Interoperability endpoints

  • Direct secure messaging: dr_edward_mcintire@yourcarecommunity.org
  • Direct secure messaging: edwardmcintire@tnvalleyuro.medalliesdirect.net

Organizations & group practices 1

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 5

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": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426204800000",
    "number": "1184689788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 BERYWOOD TRL NW",
            "address_2": "SUITE B",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373125287",
            "telephone_number": "423-472-3201",
            "fax_number": "423-476-4949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 BERYWOOD TRL NW",
            "address_2": "SUITE B",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373125287",
            "telephone_number": "423-472-3201",
            "fax_number": "423-476-4949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTIRE",
        "first_name": "EDWARD",
        "middle_name": "M",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-18",
        "last_updated": "2015-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "TN",
            "license": "MD28981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, TN

Sources for this page

Verify at the official NPI Registry.