Individual provider Active NPI

Philip D Tweedy, M.D.

  • Internal Medicine Physician
  • Hannibal, MO
National Provider Identifier
1376522870
Registry record updated Mar 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2003004610 Issued in MO
Practice address
100 Medical Dr
Hannibal, MO 63401-6877
Phone
(573) 231-3124
Fax
(573) 231-3715
NPI assigned
Jan 12, 2006
Last updated
Mar 4, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2003004610 MO Primary

Addresses

Primary practice location

100 Medical Dr
Hannibal, MO 63401-6877

Mailing address

100 Medical Dr
P.O. Box 311
Hannibal, MO 63401-6877
Phone (573) 231-3124

Other identifiers 1

IdentifierTypeStateIssuer
208380907MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address PTweedy@hannibalclinic.directbygreenway.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20250623003379 IA Practitioner - Family Practice 0143360412 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Henry County Health Center Inc CurrentSince Jun 1, 2025 Accepting new patients

Locations

3285 Main St
Keokuk, IA 52632
Phone (319) 524-6274

407 S White St
Mt Pleasant, IA 52641
Phone (319) 385-6110

1221 S Gear Ave
West Burlington, IA 52655
Phone (319) 768-3622

Interoperability endpoints

  • Direct secure messaging: ptweedy@hannibalclinic.directbygreenway.com

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": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614816000000",
    "number": "1376522870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MEDICAL DR",
            "address_2": "P.O. BOX 311",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634016877",
            "telephone_number": "573-231-3124",
            "fax_number": "573-231-3715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MEDICAL DR",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634016877",
            "telephone_number": "573-231-3124",
            "fax_number": "573-231-3715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TWEEDY",
        "first_name": "PHILIP",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-12",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2003004610",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208380907",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "PTweedy@hannibalclinic.directbygreenway.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "100 Medical Dr",
            "city": "Hannibal",
            "state": "MO",
            "country_code": "US",
            "postal_code": "634016877",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hannibal, MO

Sources for this page

Verify at the official NPI Registry.