Darren Kendrick Adderly II, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

54818 Issued in TN

Practice address

12901 Bruce B Downs Blvd # 41
Tampa, FL 33612-4742

Phone

(813) 259-8725

NPI assigned

May 22, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Manchester Center for Rehabilitation and Healing LLC

  • Skilled Nursing Facility
  • Manchester, TN
  • NPI 1871156638

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

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.

• Elite Physicians Group

  • Internal Medicine Physician
  • Brentwood, TN
  • NPI 1104315373
  Medicare reassignment NPD
• Progressive Care Medical Group of TN PLLC

  • Internal Medicine Physician
  • Gallatin, TN
  • NPI 1164939039
  Medicare reassignment NPD
• Bethany Center for Rehabilitation and Healing LLC

  • Skilled Nursing Facility
  • Nashville, TN
  • NPI 1083151179
  NPD (past)
• Madison Pointe Center for Rehabilitation and Healing LLC

  • Skilled Nursing Facility
  • Madison, TN
  • NPI 1538656939
  NPD (past)
• Manchester Center for Rehabilitation and Healing LLC

  • Skilled Nursing Facility
  • Manchester, TN
  • NPI 1871156638
  NPD (past)

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

{
    "created_epoch": "1337644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621987200000",
    "number": "1386904522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12901 BRUCE B DOWNS BLVD # 41",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336124742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12901 BRUCE B DOWNS BLVD # 41",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336124742",
            "telephone_number": "813-259-8725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADDERLY",
        "first_name": "DARREN",
        "middle_name": "KENDRICK",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-22",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TN",
            "license": "54818",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "54818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adaptive, LLC
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• Robert Stephen Adcock, MSSW
• Jennifer Judith Addae, BS
• Nicolette Chantelle Adderton, DO
• Maria Esperanza Addessi, CRNA
• Addis Car Servive Inc (Addis Taxi, Addis Care)
• Cecelia Addison
• Miriam Elisabeth Additon, ARNP

• Internal Medicine Physician in Tampa, FL
• Providers in Tampa, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.