Individual provider Active NPI

Andrew P Daigle, MD

  • Emergency Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1780692079
Registry record updated Feb 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
56034 Issued in TN
Practice address
4266 Sunbeam Rd
Jacksonville, FL 32257-2425
Phone
(904) 407-7700
Fax
(904) 407-6001
NPI assigned
Aug 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2021

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X ME61517 FL
Family Medicine Physician 207Q00000X 13573 SC
Family Medicine Physician 207Q00000X 27686 AL
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X 0101246311 VA
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X 61517 FL
Emergency Medicine Physician 207P00000X 56034 TN Primary

Addresses

Primary practice location

4266 Sunbeam Rd
Jacksonville, FL 32257-2425

Mailing address

4266 Sunbeam Rd
Jacksonville, FL 32257-2425
Phone (904) 407-7700

Other identifiers 5

IdentifierTypeStateIssuer
203013OtherSCMEDCOST
5908498MedicaidNC
7227499OtherSCAETNA
C06778OtherVAGROUP PTAN
135730MedicaidSC

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
I20190819001177 TN Practitioner - Emergency Medicine 3173588662 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Louisiana State University School of Medicine in New Orleans, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Middle Tennessee Emergency Physicians, P.C.Group PAC ID 3678464526, 85 clinicians

Practice addresses (Care Compare)

2000 Church St
Nashville, TN 37236-0002
Phone (615) 284-5555

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME61517FLMDEmergency Medicine Physician
56034TNMDEmergency Medicine Physician
27686ALMDFamily Medicine Physician
61517FLMDHospice and Palliative Medicine (Family Medicine) Physician
0101246311VAMDHospice and Palliative Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Middle Tennessee Emergency Physicians PC Emergency Medicine CurrentSince Jun 1, 2019 Accepting new patients
Bon Secours-St. Mary'S Hospital of Richmond, Inc. Past Accepting new patients
Panhandle Emergency Physicians a Div of Sacred Heart Hosp Pensacola Emergency Medicine Past Accepting new patients

Locations

1224 Trotwood Ave
Columbia, TN 38401
Phone (931) 380-4072

1080 N Ellington Pkwy
Lewisburg, TN 37091
Phone (615) 359-6241

1559 Sparta St
McMinnville, TN 37110
Phone (615) 406-9544

5127 Veterans Pkwy
Murfreesboro, TN 37128
Phone (615) 396-4100

1700 Medical Center Pkwy
Murfreesboro, TN 37129
Phone (615) 396-4100

2000 Church St
Nashville, TN 37236
Phone (615) 284-4672

4220 Harding Pike
Nashville, TN 37205
Phone (615) 222-2111

520 W Main St
Smithville, TN 37166
Phone (615) 215-5000

401 Sewell Dr
Sparta, TN 38583
Phone (931) 738-2164

324 Doolittle Rd
Woodbury, TN 37190
Phone (615) 563-4001

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 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": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613347200000",
    "number": "1780692079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4266 SUNBEAM RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322572425",
            "telephone_number": "904-407-7700",
            "fax_number": "904-407-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4266 SUNBEAM RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322572425",
            "telephone_number": "904-407-7700",
            "fax_number": "904-407-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAIGLE",
        "first_name": "ANDREW",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2021-02-15",
        "certification_date": "2021-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME61517",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "13573",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "27686",
            "primary": false
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "VA",
            "license": "0101246311",
            "primary": false
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "FL",
            "license": "61517",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "56034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "203013",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5908498",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7227499",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "C06778",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135730",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.