Individual provider Active NPI

William David Dunavant III, MD

  • Surgery Physician
  • Collierville, TN
National Provider Identifier
1659441889
Registry record updated Sep 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
TNMD0000035284 Issued in TN
Practice address
1500 W Poplar Ave Ste 304
Collierville, TN 38017-0601
Phone
(901) 767-8301
Fax
(901) 767-8302
NPI assigned
Nov 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X TNMD0000035284 TN Primary

Addresses

Primary practice location

1500 W Poplar Ave Ste 304
Collierville, TN 38017-0601

Mailing address

PO Box 381795
Germantown, TN 38183-1795
Phone (901) 767-8301

Other identifiers 2

IdentifierTypeStateIssuer
4014338OtherTNBLUE CROSS OF TN
7750269OtherTNAETNA

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
I20110401000342 TN Practitioner - General Surgery 6608050497 Reassigns benefits to 1 organization
Practice locations: Collierville, TN

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Mississippi School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1500 W Poplar Ave
Collierville, TN 38017-0601

36 Capital Way
Suite E
Atoka, TN 38004-7986
Phone (901) 837-6801

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.87 of 100Reported as group
Quality
64.75
Promoting interoperability
100
Improvement activities
40
Cost
74.81

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35284TNMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Memorial Medical Group Inc Surgery CurrentSince Oct 1, 2020 Accepting new patients
Baptist Memorial Medical Group Inc CurrentSince Oct 1, 2020 Accepting new patients
Baptist Memorial Health Services, Inc. of Mississippi Past Accepting new patients

Locations

36 Capital Way
Ste E
Atoka, TN 38004
Phone (901) 837-6801

1500 W Poplar Ave
Ste 304
Collierville, TN 38017
Phone (901) 578-2538

1500 W Poplar Ave
Ste 206
Collierville, TN 38017
Phone (901) 227-4067

1500 W Poplar Ave
Collierville, TN 38017
Phone (901) 227-8140

1500 W Poplar Ave
Ste 202
Collierville, TN 38017
Phone (901) 861-5111

6027 Walnut Grove Rd
Ste 118
Memphis, TN 38120
Phone (901) 767-8301

Interoperability endpoints

  • Direct secure messaging: wdunavant34904@mlh.direct-ci.com
  • Direct secure messaging: wdunavant11784@direct.bmhcc.org

Organizations & group practices 3

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 1

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": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601337600000",
    "number": "1659441889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 381795",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381831795",
            "telephone_number": "901-767-8301",
            "fax_number": "901-767-8302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 W POPLAR AVE STE 304",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380170601",
            "telephone_number": "901-767-8301",
            "fax_number": "901-767-8302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNAVANT",
        "first_name": "WILLIAM",
        "middle_name": "DAVID",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "TNMD0000035284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF TN",
            "identifier": "4014338",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7750269",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Collierville, TN

Sources for this page

Verify at the official NPI Registry.