Stephanie Demetric Anderson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

46418 Issued in KY

Practice address

294 Summar Dr
Jackson, TN 38301-3915

Phone

(731) 423-1932

Fax

(731) 410-0367

NPI assigned

Mar 29, 2011

Last updated

Jun 27, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Family Practice

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeastern Emergency Physicians LLCGroup PAC ID 2466364997, 776 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hospice of West Tennessee Hospice, Jackson, TN, CCN 441514
• Saint Francis Bartlett Medical Center Hospital, Bartlett, TN, CCN 440228
• Jackson-Madison County General Hospital Hospital, Jackson, TN, CCN 440002

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Southeastern Emergency Physicians LLC

  • Emergency Medicine Physician
  • Maysville, KY
  • NPI 1356379382

  TN

  Medicare reassignment Care Compare group NPD
• Creative Healthcare, PLLC

  • Internal Medicine Physician
  • Nashville, TN
  • NPI 1205072303
  Medicare reassignment NPD
• Emergency Medical Care Facilities PC

  • Emergency Medicine Physician
  • Jackson, TN
  • NPI 1538345855
  Medicare reassignment NPD
• University of Tennessee

  • Family Medicine Physician
  • Jackson, TN
  • NPI 1780686436
  Medicare reassignment NPD
• West Tennessee Medical Group Inc

  • Internal Medicine Physician
  • Jackson, TN
  • NPI 1053615955

  Family Medicine

  Medicare reassignment NPD
• University of Tennessee

  dba Univ. of TN Health Science Center College of Nursing

  • Family Nurse Practitioner
  • Memphis, TN
  • NPI 1174221337
  NPD
• WT University Medical Associates Inc

  dba West Tennessee Medical Group UT Medicine

  • Family Medicine Physician
  • Jackson, TN
  • NPI 1023572344
  NPD
• Elite Emergency Services of Kentucky, PLLC

  • Emergency Medicine Physician
  • Princeton, KY
  • NPI 1285909671

  Family Medicine

  NPD (past)

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

• Jackson Madison County General Hospital

  • General Acute Care Hospital
  • Jackson, TN
  • NPI 1093705428
  Care Compare affiliation
• Jackson-Madison County General Hospital

  dba Hospice of West Tennessee

  • Community Based Hospice Care Agency
  • Jackson, TN
  • NPI 1104816966
  Care Compare affiliation
• Saint Francis Hospital - Bartlett, Inc.

  dba St. Francis Hospital-Bartlett

  • General Acute Care Hospital
  • Bartlett, TN
  • NPI 1811929151
  Care Compare affiliation

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

{
    "created_epoch": "1301356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403827200000",
    "number": "1891084935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "294 SUMMAR DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013915",
            "telephone_number": "731-423-1932",
            "fax_number": "731-410-0367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "294 SUMMAR DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013915",
            "telephone_number": "731-423-1932",
            "fax_number": "731-410-0367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "STEPHANIE",
        "middle_name": "DEMETRIC",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-29",
        "last_updated": "2014-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "46418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia G Anderson, CRNA
• Edward J Anderson, CM
• Jonathan O Anderson, CRNA
• Keith Anderson Jr., MD
• Mary Elisabeth Neal Anderson, MD
• Rhiannon Michelle Andresen, FNP-C
• William Farr Andrews Jr., DDS
• Anesthesia Services Associates, PLLC
• Laila Annamer
• Brittany Alexis Anthony

• Family Medicine Physician in Jackson, TN
• Providers in Jackson, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2014; 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.