Individual provider Active NPI

Harold M Antwine, MD

  • Orthopaedic Surgery Physician
  • Jackson, TN
National Provider Identifier
1538268164
Registry record updated Nov 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
MD30684 Issued in TN
Practice address
24 Physicians Dr
Jackson, TN 38305
Phone
(731) 661-9825
Fax
(731) 668-6757
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X MD30684 TN Primary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X MD30684 TN

Addresses

Primary practice location

24 Physicians Dr
Jackson, TN 38305

Mailing address

24 Physicians Dr
Jackson, TN 38305
Phone (731) 661-9825

Other identifiers 1

IdentifierTypeStateIssuer
Q010031MedicaidTN

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
I20120412000352 TN Practitioner - Orthopedic Surgery 6608037957 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Tulane University School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Tennessee Bone and Joint Clinic PCGroup PAC ID 7517940182, 64 clinicians

Practice addresses (Care Compare)

50 Capital Ave
Jackson, TN 38305-5507
Phone (731) 661-9825

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.05 of 100Reported as group
Promoting interoperability
98
Improvement activities
40
Cost
73.85

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement11
Knee replacement21
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)12

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD30684TNMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Tennessee Bone and Joint Clinic PC Orthopaedic Surgery CurrentSince Jun 1, 2002 Accepting new patients
Jackson Clinic PA Past Accepting new patients

Locations

24 Physicians Dr
Jackson, TN 38305
Phone (731) 661-9825

50 Capital Ave
Jackson, TN 38305
Phone (731) 661-9825

202 W Church St
Lexington, TN 38351
Phone (731) 450-2663

1940 Pickwick St
Savannah, TN 38372
Phone 7319251196 ext. 1197

Interoperability endpoints

  • Direct secure messaging: harold.antwine.1@3533.direct.athenahealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446422400000",
    "number": "1538268164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 PHYSICIANS DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "38305",
            "telephone_number": "731-661-9825",
            "fax_number": "731-668-6757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 PHYSICIANS DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "38305",
            "telephone_number": "731-661-9825",
            "fax_number": "731-668-6757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTWINE",
        "first_name": "HAROLD",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2015-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TN",
            "license": "MD30684",
            "primary": true
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "TN",
            "license": "MD30684",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q010031",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.