Individual provider Active NPI

Donald Meyers, DDS

  • Dentist
  • Antioch, TN
National Provider Identifier
1215083852
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2161 Issued in TN
Practice address
5352 Hickory Hollow Pkwy
Antioch, TN 37013-3128
Phone
(615) 731-0889
Fax
(615) 731-0869
NPI assigned
Jan 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2161 TN Primary

Addresses

Primary practice location

5352 Hickory Hollow Pkwy
Antioch, TN 37013-3128

Mailing address

5352 Hickory Hollow Pkwy
Antioch, TN 37013-3128
Phone (615) 731-0889

Other identifiers 1

IdentifierTypeStateIssuer
16044MedicaidTN

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160519000064 TN Order and Referring Only - Other (Non-Physician) 6608165352

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
2161TNMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Heartland Dental Care of Tennessee, PC Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215083852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5352 HICKORY HOLLOW PKWY",
            "city": "ANTIOCH",
            "state": "TN",
            "postal_code": "370133128",
            "telephone_number": "615-731-0889",
            "fax_number": "615-731-0869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5352 HICKORY HOLLOW PKWY",
            "city": "ANTIOCH",
            "state": "TN",
            "postal_code": "370133128",
            "telephone_number": "615-731-0889",
            "fax_number": "615-731-0869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYERS",
        "first_name": "DONALD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "2161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "16044",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Antioch, TN

Sources for this page

Verify at the official NPI Registry.