Individual provider Active NPI

Samer Loleh, MD

  • Pediatrics Physician
  • Shelbyville, TN
National Provider Identifier
1104878248
Registry record updated Jan 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
37838 Issued in TN
Practice address
220 W Cedar St Ste 208
Shelbyville, TN 37160-2838
Phone
(931) 684-2802
Fax
(877) 671-2402
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 37838 TN Primary

Addresses

Primary practice location

220 W Cedar St Ste 208
Shelbyville, TN 37160-2838

Mailing address

220 W Cedar St
Shelbyville, TN 37160-2838
Phone (931) 684-2802

Other identifiers 1

IdentifierTypeStateIssuer
1505186MedicaidTN

Other names 1

  • Samer Loleh Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healthy Kids, LLC Pediatrics Current Accepting new patients
Carmel Clinic Corporation Past Accepting new patients
Centennial Pediatrics PC Pediatrics PastSince Oct 1, 2012 Accepting new patients
Total Family Care and Walk-in Clinic, LLC PastSince Dec 27, 2023 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JFDFAD/Endpoint/JFDFAD
  • Direct secure messaging: samer.loleh@h1.eclinicaldirectplus.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578528000000",
    "number": "1104878248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 W CEDAR ST",
            "city": "SHELBYVILLE",
            "state": "TN",
            "postal_code": "371602838",
            "telephone_number": "931-684-2802",
            "fax_number": "877-671-2402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 W CEDAR ST STE 208",
            "city": "SHELBYVILLE",
            "state": "TN",
            "postal_code": "371602838",
            "telephone_number": "931-684-2802",
            "fax_number": "877-671-2402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOLEH",
        "first_name": "SAMER",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2020-01-09",
        "certification_date": "2020-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "37838",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1505186",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMER",
            "last_name": "LOLEH",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Shelbyville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.