David Alfredson MD PC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

MD 13280 Issued in TN

Legal business name

DAVID ALFREDSON MD PC

Practice address

529 W Commerce St
Lewisburg, TN 37091-3219

Phone

(931) 276-2234

Fax

(931) 276-2233

NPI assigned

Mar 25, 2007

Last updated

Oct 28, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

David Alfredson, M.D.NPI 1720105547

Title

President

Phone

(931) 276-2234

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David Alfredson, M.D.

  • Diagnostic Radiology Physician
  • Lewisburg, TN
  • NPI 1720105547
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1174780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730073600000",
    "number": "1487771200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2361",
            "city": "LEWISBURG",
            "state": "TN",
            "postal_code": "370911361",
            "telephone_number": "931-276-2234",
            "fax_number": "931-276-2233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "529 W COMMERCE ST",
            "city": "LEWISBURG",
            "state": "TN",
            "postal_code": "370913219",
            "telephone_number": "931-276-2234",
            "fax_number": "931-276-2233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID ALFREDSON MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-25",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A",
        "authorized_official_last_name": "ALFREDSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "931-276-2234",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TN",
            "license": "MD 13280",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TN",
            "license": "MD 13280",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD TN",
            "identifier": "149997",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3383775",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Diagnostic Radiology Physician in Lewisburg, TN
• Providers in Lewisburg, TN by specialty
• Diagnostic Radiology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.