Active NPI
Philip D Tweedy, M.D.
- Internal Medicine Physician
- Hannibal, MO
National Provider Identifier
1376522870
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 2003004610
- 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, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 208380907 | Medicaid | MO |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Henry County Health Center Inc | Current | 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
- 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.
-
- General Practice Physician
- Mt Pleasant, IA
- NPI 1871177477
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.