John David Anderson, MD
Individual provider Active NPI Internal Medicine Physician · Valdosta, GA
NPI 1316947484 · NPPES record last updated Dec 17, 2009
Key facts
- NPI
- 1316947484
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- GA021630 (GA)
- Practice address
- 2704 N Oak St
BLDG O
Valdosta, GA 31602-1744 - Phone
- (229) 247-2350
- Fax
- (229) 247-6826
- NPI assigned
- Jul 29, 2005
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 14
Hospital & facility affiliations 7
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Emory University School of Medicine, 1979
- Medicare assignment
- May accept Medicare assignment
- Group practices
- South Georgia Medical Center Inc
Apogee Medical Group Georgia
Select Rehabilitation, LLC
Practice addresses (Care Compare)
2501 N Patterson St
Valdosta, GA 31602-1735
2600 Compass Rd
Glenview, IL 60026-8001
2704 N Oak St
BLDG O
Valdosta, GA 31602-1793
Phone (229) 247-2350
Hospital & facility affiliations
- Georgia Home Health Services
- Amedisys Home Health of Valdosta
- Crescent Home Health
- Hospice of South Georgia
- SGMC Health
- SGMC Berrien Campus
- SGMC Health Lanier
Merit-based Incentive Payment System (MIPS)
- Final score
- 99.1 of 100
- Quality
- 98.19
- Improvement activities
- 40
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Promoting interoperability
- 100
- Improvement activities
- 40
Merit-based Incentive Payment System (MIPS)
- Final score
- 87.29 of 100
- Quality
- 70.79
- Improvement activities
- 40
- Cost
- 81.32
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal or shaving of skin growth | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- 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 |
|---|---|---|---|---|
| I20070726000417 | GA | Practitioner - Internal Medicine |
0345341921 |
Reassigns benefits to 3 organizations Practice locations: Valdosta, GA |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| GA021630 | GA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hospital Authority of Valdosta and Lowndes County Georgia | Current |
Accepting new patients | |
| Hospital Authority of Valdosta and Lowndes County Georgia | Current | Accepting new patients | |
| South Georgia Medical Center Inc | Current |
Accepting new patients | |
| South Georgia Medical Center Inc | Current |
Accepting new patients | |
| Hospital Authority of Valdosta and Lowndes County, Georgia | Current |
Accepting new patients | |
| Hospital Authority of Valdosta and Lowndes County Georgia | Current | Accepting new patients | |
| Apogee Medical Group Georgia | Internal Medicine | Current |
Accepting new patients |
| Hospital Authority of the City of Bainbridge and Decatur County | Past | Accepting new patients |
Locations
705 Dixie St
Carrollton, GA 30117
Phone (770) 812-9666
915 Gordon Ave
Thomasville, GA 31792
Phone (229) 228-8575
4280 N Valdosta Rd
Valdosta, GA 31602
Phone (229) 433-7350
2501 N Patterson St
Valdosta, GA 31602
Phone (229) 259-4139
601 Dallas Hwy
Villa Rica, GA 30180
Phone (770) 456-3000
Interoperability endpoints
- jdanderson@johndandersonmd.ssdirect.aprima.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | GA021630 | GA | Yes |
Addresses
Primary practice location
2704 N Oak St
BLDG O
Valdosta, GA 31602-1744
Mailing address
2704 N Oak St
BLDG O
Valdosta, GA 31602-1744
Phone (229) 247-2350
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00229919C | Medicaid | GA | |
| 11D0265529 | Other | CLIA | |
| 2641658-01 | Medicaid | FL |
Other providers in Valdosta, GA
- Keri L Amerson
- Latecia Ammons
- Laura Morgan Ammons
- Amy H. Wells, LCSW PC
- Amber Anderson
- John Joseph Anderson Sr.
- Justin Shaw Anderson
- Sharyshma Deshun Anderson
- Thomas L Anderson
- F. Tirrell Andrews
All providers in Valdosta, GA · Internal Medicine Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 17, 2009. 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).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.