Individual provider Active NPI

William D Daniel, DO

  • Family Medicine Physician
  • Manchester, TN
National Provider Identifier
1497851786
Registry record updated Apr 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO 738 Issued in TN
Practice address
1615 McMinnville Hwy
Manchester, TN 37355-3179
Phone
(931) 728-6205
Fax
(931) 723-3194
NPI assigned
Sep 15, 2006
Last updated
Apr 4, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DO 738 TN Primary

Addresses

Primary practice location

1615 McMinnville Hwy
Manchester, TN 37355-3179

Mailing address

1615 McMinnville Hwy
Manchester, TN 37355-3179
Phone (931) 728-6205

Other identifiers 5

IdentifierTypeStateIssuer
103G702278OtherTNGROUP TRANSACTION ACCESS NUMBER
4139428OtherTNTENNCARE
3302198MedicaidTN
4139428OtherTNBLUE CROSS
TN0105OtherTNAMERICHOICE

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040525000398 TN Practitioner - Family Practice 3577554864 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Leonard Medical School, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coffee Medical Group LLCGroup PAC ID 1850208794, 22 clinicians
Coffee County Hospital Group IncGroup PAC ID 1456317783, 87 clinicians

Practice addresses (Care Compare)

481 Interstate Dr
Manchester, TN 37355

481 Interstate Dr
Manchester, TN 37355-3108
Phone (931) 728-6354

482 Interstate Dr
Suite a
Manchester, TN 37355-3109
Phone (931) 728-4718

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO 738TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coffee Medical Group LLC CurrentSince Mar 26, 2024 Accepting new patients
Coffee Medical Group LLC CurrentSince Mar 26, 2024 Accepting new patients
Coffee County Hospital Group, Inc CurrentSince Jan 27, 2012 Accepting new patients
Coffee Medical Group LLC CurrentSince Jan 27, 2012 Accepting new patients

Locations

1615 McMinnville Hwy
Manchester, TN 37355
Phone (931) 450-5062

481 Interstate Dr
Manchester, TN 37355
Phone (931) 728-3586

482 Interstate Dr
Manchester, TN 37355
Phone (931) 728-4718

1801 N Jackson St
Tullahoma, TN 37388
Phone (931) 393-3000

Interoperability endpoints

  • Direct secure messaging: william.daniel@mcrhc.eclinicaldirectplus.com

Organizations & group practices 4

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333497600000",
    "number": "1497851786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 MCMINNVILLE HWY",
            "city": "MANCHESTER",
            "state": "TN",
            "postal_code": "373553179",
            "telephone_number": "931-728-6205",
            "fax_number": "931-723-3194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 MCMINNVILLE HWY",
            "city": "MANCHESTER",
            "state": "TN",
            "postal_code": "373553179",
            "telephone_number": "931-728-6205",
            "fax_number": "931-723-3194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIEL",
        "first_name": "WILLIAM",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2012-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "DO 738",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP TRANSACTION ACCESS NUMBER",
            "identifier": "103G702278",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TENNCARE",
            "identifier": "4139428",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3302198",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "4139428",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE",
            "identifier": "TN0105",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, TN

Sources for this page

Verify at the official NPI Registry.