Individual provider Active NPI

Donald M Sandercock II, DO

  • Orthopaedic Surgery Physician
  • Lenoir City, TN
National Provider Identifier
1891776068
Registry record updated Oct 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
1736 Issued in TN
Practice address
401 Town Creek Rd E Ste 101
Lenoir City, TN 37772-5612
Phone
(865) 271-6160
Fax
(865) 374-1090
NPI assigned
Nov 7, 2005
Last updated
Oct 8, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 036-121694 IL
Orthopaedic Surgery Physician 207X00000X 1736 TN Primary
Orthopaedic Surgery Physician 207X00000X 5101013131 MI

Addresses

Primary practice location

401 Town Creek Rd E Ste 101
Lenoir City, TN 37772-5612

Mailing address

401 Town Creek Rd E Ste 101
Lenoir City, TN 37772-5612
Phone (865) 271-6160

Other identifiers 1

IdentifierTypeStateIssuer
Q106480MedicaidTN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sandercock.donald@covenanthealth.cernerdirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20060330000516 TN Practitioner - Orthopedic Surgery 1759399892 Reassigns benefits to 1 organization
I20090326000230 IL Practitioner - Orthopedic Surgery 1759399892 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sarah Bush Lincoln Health CenterGroup PAC ID 5092614867, 411 clinicians
Covenant Medical Group IncGroup PAC ID 2860305463, 363 clinicians

Practice addresses (Care Compare)

1004 Health Ctr Dr
Suite 100
Mattoon, IL 61938-4607
Phone (217) 238-3435

111 Clyde St
Loudon, TN 37774-1600
Phone (865) 458-1554

401 Town Creek Rd E
Suite 101
Lenoir City, TN 37772-5612
Phone (865) 271-6160

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.96 of 100Reported as apm
Quality
69.5
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
91.05 of 100Reported as apm
Quality
72.1
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement1-10
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1736TNMDRegistered Dietitian
036-121694ILMDOrthopaedic Surgery Physician
5101013131MIMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Group, Inc CurrentSince Oct 1, 2025 Accepting new patients
Covenant Medical Group, Inc. Orthopaedic Surgery CurrentSince Oct 1, 2025 Accepting new patients
Sarah Bush Lincoln Health Center CurrentSince Sep 30, 2008 Accepting new patients
Sarah Bush Lincoln Health Center Current Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Summit Medical Group, PLLC Past Accepting new patients
Sarah Bush Lincoln Health Center Past Accepting new patients
Orthopaedic Center of Greeneville Orthopaedic Surgery Past Accepting new patients
Crossville Medical Group PA PastSince Oct 12, 2025 Accepting new patients

Locations

1005 Health Center Dr
Ste 201
Mattoon, IL 61938
Phone (217) 238-6055

101 Professional Plz
Mattoon, IL 61938
Phone (217) 238-3730

1000 Health Center Dr
Mattoon, IL 61938
Phone (217) 258-2389

1004 Health Center Dr
Ste 100
Mattoon, IL 61938
Phone (217) 238-3435

1007 Health Center Dr
Mattoon, IL 61938
Phone (217) 258-7400

1000 Health Center Dr
Ste 401
Mattoon, IL 61938
Phone (217) 258-2409

Dept 888179
Knoxville, TN 37995

1400 Centerpoint Blvd
Ste 158
Knoxville, TN 37932

401 Town Creek Rd E
Ste 101
Lenoir City, TN 37772
Phone (865) 271-6160

111 Clyde St
Loudon, TN 37774
Phone (865) 458-1554

Interoperability endpoints

  • Direct secure messaging: sandercock.donald@covenanthealth.cernerdirect.com

Organizations & group practices 9

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 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": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759881600000",
    "number": "1891776068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 TOWN CREEK RD E STE 101",
            "city": "LENOIR CITY",
            "state": "TN",
            "postal_code": "377725612",
            "telephone_number": "865-271-6160",
            "fax_number": "865-374-1090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 TOWN CREEK RD E STE 101",
            "city": "LENOIR CITY",
            "state": "TN",
            "postal_code": "377725612",
            "telephone_number": "865-271-6160",
            "fax_number": "865-374-1090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERCOCK",
        "first_name": "DONALD",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-07",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "036-121694",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TN",
            "license": "1736",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "5101013131",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q106480",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sandercock.donald@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "401 Town Creek Rd E Ste 101",
            "city": "Lenoir City",
            "state": "TN",
            "country_code": "US",
            "postal_code": "377725612",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lenoir City, TN

Sources for this page

Verify at the official NPI Registry.