CMS-1500 Box 24J / 33a • NPI
1417995291
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
207P00000X (CMS 93)
Board-Certified Emergency Medicine Physician (ER / Trauma Doctor)
Box 32 Service Location & ZIP+4
712 N WOOD ST, EMERGENCY DEPARTMENT, GILMER, TX, 75644-1751
✓ 9-Digit EDI 837 ZIP+4 (75644-1751)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1417995291 (WILLIAM DOUGLAS ANDERSON, MD) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Medicare Part B
✓ Eligible
DMEPOS Ordering
✓ Eligible
Home Health (HHA)
✓ Eligible
Power Mobility
✓ Eligible
Hospice Referring
✓ Eligible
Empirical CMS Medicare Claims, CPT Utilization & Part D Prescribing (NPI #1417995291)
Medicare Beneficiaries
91
Total Billed Services
137
Distinct CPT/HCPCS Codes
30
Medicare Allowed Total
$13,973.21
Actual Top Billed CPT / HCPCS Procedures (CMS Part B)
| CPT / HCPCS | Clinical Procedure Description | Services |
|---|---|---|
71045 | X-ray of chest, 1 view | 13 |
99284 | Emergency department visit with moderate level of medical decision making | 35 |
99285 | Emergency department visit with high level of medical decision making | 41 |
Actual Top Prescribed Medications (CMS Part D)
| Brand / Generic Medication | Total Claims | Patients |
|---|---|---|
| Acetaminophen-Codeine Acetaminophen With Codeine | 13 | 13 |
| Amoxicillin Amoxicillin | 21 | 16 |
| Celecoxib Celecoxib | 24 | 24 |
| Levofloxacin Levofloxacin | 22 | 20 |
| Naproxen Naproxen | 12 | 12 |
| Ondansetron Odt Ondansetron | 12 | 12 |
| Prednisone Prednisone | 23 | 22 |
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1417995291 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | WILLIAM DOUGLAS ANDERSON, MD |
| Plain-English Specialty | Board-Certified Emergency Medicine Physician (ER / Trauma Doctor) NUCC Code: 207P00000X (Emergency Medicine) |
| Certifying / Licensing Body | American Board of Emergency Medicine (ABEM) |
| Practice Location Address | 712 N WOOD ST, EMERGENCY DEPARTMENT, GILMER, TX, 75644-1751 |
| Practice Telephone / Fax | Tel: (903) 841-7100 |
| Administrative Mailing Address | 861 SW 78TH AVE, PLANTATION, FL, 33324-3229 |
| Enumeration & Last Sync | Enumerated: 2006-06-03 | CMS Record Updated: 2010-03-08 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (207P00000X)
What Does Taxonomy Code 207P00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207P00000X translates to:
"Board-Certified Emergency Medicine Physician (ER / Trauma Doctor)"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (WILLIAM DOUGLAS ANDERSON, MD)
Typical CPT / Diagnostic Procedures:- Level 4 & Level 5 Emergency Department Resuscitation (CPT 99284–99285)
- Point-of-Care Emergency Ultrasound (eFAST), Intubation & Central Line Placement
- Acute Laceration Repair, Tetanus Prophylaxis & Fracture Splinting
- Epinephrine Auto-Injectors / IV Infusions, Atropine & Amiodarone
- Tetanus Toxoid / Tdap & Tetanus Immunoglobulin (TIG)
- Empiric Sepsis Antibiotics, Parenteral Ketorolac & Ondansetron
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
207P00000X — Emergency MedicinePlain English: Board-Certified Emergency Medicine Physician (ER / Trauma Doctor) | State: TX | License: H3365 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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