Individual provider Active NPI

Shant Hagop Garabedian, DO

  • Emergency Medicine Physician
  • Jackson, TN
National Provider Identifier
1124058276
Registry record updated Feb 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
1274 Issued in TN
Practice address
367 Hospital Blvd
Jackson, TN 38305-2080
Phone
(731) 661-2095
NPI assigned
Jul 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 1274 TN Primary

Addresses

Primary practice location

367 Hospital Blvd
Jackson, TN 38305-2080

Mailing address

118 Barrett PL
Jackson, TN 38305-1918
Phone (731) 695-8215

Other identifiers 4

IdentifierTypeStateIssuer
3830111MedicaidTN
P00268882OtherRR MEDICARE
4105328OtherBCBS
3830112MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, KY, AL3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20040909000103 TN Practitioner - Emergency MedicinePractitioner - Family Practice 5799751905 Reassigns benefits to 8 organizations
I20240828002422 KY Practitioner - Family Practice 5799751905 Reassigns benefits to 1 organization
I20260522003558 AL Practitioner - Emergency Medicine 5799751905 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Racers Emergency Physicians PLLCGroup PAC ID 6507908985, 3 clinicians

Practice addresses (Care Compare)

803 Poplar St
Murray, KY 42071-2432
Phone (954) 939-5000

Hospital & facility affiliations

  • Murray-Calloway County Hospital Hospital, Murray, KY, CCN 180027

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as virtual group
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1274TNMDSurgical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist South Emergency Physicians, PLLC Emergency Medicine CurrentSince Jan 1, 2025 Accepting new patients
Emergency Coverage, LLC Emergency Medicine CurrentSince Oct 8, 2024 Accepting new patients
Germantown Emergency Physicians, PLLC Emergency Medicine CurrentSince Jan 1, 2025 Accepting new patients
Racers Emergency Physicians PLLC Emergency Medicine CurrentSince Jul 1, 2024 Accepting new patients
Methodist University Emergency Physicians PLLC Emergency Medicine CurrentSince Jan 1, 2025 Accepting new patients
Methodist North Emergency Physicians, PLLC Emergency Medicine CurrentSince Jan 1, 2025 Accepting new patients
T M Carr MD PC Emergency Medicine CurrentSince Dec 28, 2023 Accepting new patients
Coffee County Physician Group PC Emergency Medicine CurrentSince Nov 1, 2024 Accepting new patients
Emergency Medical Care Facilities PC Emergency Medicine CurrentSince Jun 1, 2018 Accepting new patients
Emergency Coverage Services, PC Past Accepting new patients
Cane Ridge Emergency Physicians LLC Emergency Medicine Past Accepting new patients

Locations

803 Poplar St
Murray, KY 42071
Phone (270) 762-1155

650 Nuckolls Rd
Bolivar, TN 38008
Phone (731) 541-6834

175 Hospital Dr
Camden, TN 38320
Phone (731) 584-6135

400 E Tickle St
Dyersburg, TN 38024
Phone (731) 285-2410

3525 Chere Carol Rd
Humboldt, TN 38343
Phone (731) 784-2321

620 Skyline Dr
Jackson, TN 38301
Phone (731) 541-4923

367 Hospital Blvd
Jackson, TN 38305
Phone (731) 661-2000

923 E Central Ave
La Follette, TN 37766
Phone (423) 907-1200

1607 S Locust Ave
Lawrenceburg, TN 38464
Phone (731) 287-2244

481 Interstate Dr
Manchester, TN 37355
Phone (931) 728-3586

161 Mount Pelia Rd
Martin, TN 38237
Phone (731) 587-4261

1265 Union Ave
Memphis, TN 38104
Phone (901) 516-2362

1300 Wesley Dr
Memphis, TN 38116
Phone (901) 516-3700

3960 New Covington Pike
Memphis, TN 38128
Phone (901) 516-5200

7691 Poplar Ave
Memphis, TN 38138
Phone (901) 516-1290

4039 Highland St
Milan, TN 38358
Phone (731) 660-8755

301 Tyson Ave
Paris, TN 38242
Phone (731) 642-1220

935 Wayne Rd
Savannah, TN 38372
Phone (731) 925-4954

Interoperability endpoints

  • Direct secure messaging: sgarabed@yourcarecommunity.org

Organizations & group practices 12

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.

Hospital & facility affiliations 1

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": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265673600000",
    "number": "1124058276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 BARRETT PL",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383051918",
            "telephone_number": "731-695-8215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "367 HOSPITAL BLVD",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052080",
            "telephone_number": "731-661-2095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARABEDIAN",
        "first_name": "SHANT",
        "middle_name": "HAGOP",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2010-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "1274",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3830111",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00268882",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4105328",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3830112",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.