James Gregory Anderson, DDS
Individual provider Active NPI Oral and Maxillofacial Surgery (Dentist) · Clinton, TN
NPI 1619952314 · NPPES record last updated Oct 17, 2024
Key facts
- NPI
- 1619952314
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist) 1223S0112X
- License
- DS0000005390 (TN)
- Practice address
- 175 Frank Price Blvd
Clinton, TN 37716-1420 - Phone
- (865) 622-4959
- Fax
- (865) 269-4336
- NPI assigned
- Dec 14, 2005
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Maxillofacial Surgery
- Education
- University of Tennessee, HSC, College of Medicine, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
175 Frank Price Blvd
Clinton, TN 37716-1420
Phone (865) 622-4959
Hospital & facility affiliations
- University Health System, Inc
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090117000081 | TN | Practitioner - Maxillofacial Surgery | 1951496868 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS0000005390 | TN | MD | Oral and Maxillofacial Surgery (Dentist) |
| DS5390 | TN | MD | Oral and Maxillofacial Surgery (Dentist) |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) |
1223S0112X | DS5390 | TN | |
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | DS0000005390 | TN | Yes |
Addresses
Primary practice location
175 Frank Price Blvd
Clinton, TN 37716-1420
Mailing address
175 Frank Price Blvd
Clinton, TN 37716-1420
Phone (865) 622-4959
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1511863 | Medicaid | TN | |
| 1316197619 | Other | TN | GROUP NPI |
Other providers in Clinton, TN
- Anderson County Health Department
- Anderson County Medical Investors, LLC
- Anderson County Personal Services LLC
- Anderson County School System
- Anderson Oral and Maxillofacial Surgery P.C.
- Appalachia Family Dentistry
- Apple RX, LLC
- Apple RX, LLC
- Kierstan Brianna Arnold
- Jeannine Marguerite Aslinger
All providers in Clinton, TN · Oral and Maxillofacial Surgery (Dentist) in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 17, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.