Individual provider Active NPI

John Chandler Romersa, DDS

  • Dentist
  • Nashville, TN
National Provider Identifier
1114026267
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS4378 Issued in TN
Practice address
4105 Hillsboro Circle
Nashville, TN 37220
Phone
(615) 383-8834
Fax
(615) 383-8835
NPI assigned
Sep 22, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS4378 TN Primary

Addresses

Primary practice location

4105 Hillsboro Circle
Nashville, TN 37220

Mailing address

4105 Hillsboro Circle
Nashville, TN 37220
Phone (615) 383-8834

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150323000965 TN Order and Referring Only - Other (Non-Physician) 4880911320

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4378TNMDProfessional Counselor
DS4378TNMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114026267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4105 HILLSBORO CIRCLE",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "37220",
            "telephone_number": "615-383-8834",
            "fax_number": "615-383-8835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4105 HILLSBORO CIRCLE",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "37220",
            "telephone_number": "615-383-8834",
            "fax_number": "615-383-8835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMERSA",
        "first_name": "JOHN",
        "middle_name": "CHANDLER",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "DS4378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

Verify at the official NPI Registry.