David Jerry Addley, D.O.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

OS009667L Issued in PA

Practice address

2630 Holme Ave Ste 200
Philadelphia, PA 19152-3004

Phone

(215) 332-3972

Fax

(215) 331-3784

NPI assigned

Nov 15, 2006

Last updated

Apr 27, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Cardiovascular Disease (Cardiology)

Education

Philadelphia College of Osteopathic Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Tanner Medical Group IncGroup PAC ID 2769536143, 120 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tanner Medical Center - Carrollton Hospital, Carrollton, GA, CCN 110011
• Tanner Medical Center Villa Rica Hospital, Villa Rica, GA, CCN 110015
• Tanner Medical Center-East Alabama Hospital, Wedowee, AL, CCN 011306

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: daddley2021312@direct.trinity-health.org

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.

• Tanner Medical Group Inc

  • Cardiovascular Disease Physician
  • Carrollton, GA
  • NPI 1396979787

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• TMC Children's Healthcare of West Georgia

  • Medical Specialty Clinic/Center
  • Carrollton, GA
  • NPI 1518972348
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Tanner Medical Center Alabama Inc

  dba Tanner Medical Center East Alabama

  • Critical Access Hospital
  • Wedowee, AL
  • NPI 1912428301
  Care Compare affiliation
• Tanner Medical Center, Inc

  dba Tanner Health System

  • General Acute Care Hospital
  • Carrollton, GA
  • NPI 1801883780
  Care Compare affiliation
• TMC/Villa Rica Hospital, Inc

  dba Tanner Health System

  • General Acute Care Hospital
  • Villa Rica, GA
  • NPI 1851388748
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619481600000",
    "number": "1881767374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5249 CEDAR AVE",
            "address_2": "SUITE A",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191431524",
            "telephone_number": "215-471-1817",
            "fax_number": "215-471-5089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2630 HOLME AVE STE 200",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191523004",
            "telephone_number": "215-332-3972",
            "fax_number": "215-331-3784"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5249 Cedar Ave",
            "address_2": "Suite A",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191431524",
            "country_code": "US",
            "telephone_number": "215-471-1817",
            "fax_number": "215-471-5089",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADDLEY",
        "first_name": "DAVID",
        "middle_name": "JERRY",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PA",
            "license": "OS009667L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001914850",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "david.addley.1@16196.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Nazareth Physician Services Direct Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "2630 Holme Ave Ste 200",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191523004",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "david.addley.2@16196.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Nazareth Physician Services Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "2630 Holme Ave Ste 200",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191523004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Francesca Addiego, CRNA
• Eileen B Addis, LCSW
• Victoria Marie Addis, M.D.
• Aisha Ayanna Addison
• Kevin Addison, ATC
• Joan Mureen Addley, DO
• Addus Health Care Inc (Addus HomeCare)
• Editus Addy
• Ajoke Olivia Adebayo
• Oluwakemi Adedokun

• Cardiovascular Disease Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Cardiovascular Disease Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.