DR. SAMUEL JESSE II ANTHONY (DO) – Family Medicine Physician, NPI 1154986024
Family Medicine Physician
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
1,718 FAMILY PRACTICE in KY
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Provider Addresses for DR. SAMUEL JESSE II ANTHONY (DO)
82 E TENNESSEE AVE APT 220
OAK RIDGE, TN 378305496
Phone: (256) 783-4808
Type: Mailing
Langdon Street, Somerset, Pulaski County, Kentucky, 42503, United States
SOMERSET, KY 425032750
Phone: (256) 783-4808
Type: Location
20515 ASPEN DR
GRAND RAPIDS, MN 557444792
Phone:
Type: Mailing
2401 FAIRVIEW AVE N STE 145
ROSEVILLE, MN 551132710
Phone: (888) 290-1209
Fax: (833) 973-3529
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 26 Open Payments records for all available years, with a total value of $457.
Total Amount is formed as General ($457) + Research ($0) + Ownership ($0) = $457.
Last reported payment date: 2023-08-29 • Largest payer in this snapshot: Boehringer Ingelheim Pharmaceuticals, Inc. ($94).
Total Amount
$457
General + Research + Ownership
Payments
26
Total payment records
General Amount
$457
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-08-29
Latest reported date
Top Companies
Largest payers in this snapshot
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-05-03
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20221027000563 | I | Family Practice | AL | TBD |
| I20240503002699 | I | Family Practice | MN | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 37830)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | MN | |
| P O D I A T R Y | MN | |
| Nurse Practitioner | MN | |
| Emergency Medicine | ND | |
| - | ND | |
| Physician Assistant | SD | |
| Family Practice | MN | |
| Family Practice | ND | |
| Physician Assistant | ND | |
| - | MN |
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