Individual provider Active NPI

William Jarvis Beuerlein, DO

  • Anatomic Pathology & Clinical Pathology Physician
  • Morristown, TN
National Provider Identifier
1720518186
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
5003 Issued in TN
Practice address
908 W 4TH North St
Morristown, TN 37814-3894
Phone
(423) 492-9000
NPI assigned
Jun 18, 2017
Last updated
Sep 25, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X TP731 KY
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X OS17393 FL
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 5003 TN Primary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 227750 NC
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 17393 FL

Addresses

Primary practice location

908 W 4TH North St
Morristown, TN 37814-3894

Mailing address

PO Box 415000
Nashville, TN 37241-8352

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address wbeuerlein1443714@ehrdirect.mayoclinicmsg.org

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
I20230602000832 TN Practitioner - Pathology 7517230527 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Lincoln Mem Univ, Debusk Col of Osteopathic Med, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Tennessee Pathology, PLLCGroup PAC ID 7416125281, 7 clinicians

Practice addresses (Care Compare)

10820 Parkside Dr
Knoxville, TN 37934-1956
Phone (865) 218-7011

110 Hospital Dr
Jefferson City, TN 37760-5281
Phone (865) 471-2500

7565 Dannaher Dr
Powell, TN 37849-4029
Phone (865) 589-8000

908 W 4TH N St
Morristown, TN 37814-3894
Phone (423) 586-4231

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5003TNMDMental Health Counselor
17393FLMDAnatomic Pathology & Clinical Pathology Physician
TP731KYMDAnatomic Pathology & Clinical Pathology Physician
227750NCMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
East Tennessee Pathology, PLLC CurrentSince Jul 1, 2023 Accepting new patients

Locations

5700 Southwyck Blvd
Toledo, OH 43614

908 W 4th North St
Morristown, TN 37814
Phone (423) 492-9000

Organizations & group practices 1

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 5

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": "1497744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1720518186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415000",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372418352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "908 W 4TH NORTH ST",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378143894",
            "telephone_number": "423-492-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEUERLEIN",
        "first_name": "WILLIAM",
        "middle_name": "JARVIS",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-18",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "KY",
            "license": "TP731",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "FL",
            "license": "OS17393",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TN",
            "license": "5003",
            "primary": true
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NC",
            "license": "227750",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "FL",
            "license": "17393",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wbeuerlein1443714@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "4500 San Pablo Rd S",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322241865",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Morristown, TN

Sources for this page

Verify at the official NPI Registry.