Sally J Sidman, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

01042578A Issued in IN

Practice address

1206 E. National Avenue
Brazil, IN 47834

Phone

(812) 442-2700

Fax

(812) 442-2710

NPI assigned

Jul 13, 2006

Last updated

Mar 27, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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

• Inphynet Primary Care Physicians Midwest, S.C.

  • Physician Assistant
  • Fort Wayne, IN
  • NPI 1528090610

  Emergency Medicine

  NPD (past)
• Roundhouse Emergency Physicians LLC

  • Emergency Medicine Physician
  • Washington, IN
  • NPI 1841425410
  NPD (past)
• Crossroads Emergency Physicians, LLP

  • Emergency Medicine Physician
  • Effingham, IL
  • NPI 1023033982
  NPD (past)
• Illiana Emergency Physicians LLP

  • Emergency Medicine Physician
  • Greenville, IL
  • NPI 1730426941
  NPD (past)
• Illiana Emergency Physicians, LLP

  • Emergency Medicine Physician
  • Danville, IL
  • NPI 1164447058
  NPD (past)

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395878400000",
    "number": "1215952601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1206 E. NATIONAL AVENUE",
            "city": "BRAZIL",
            "state": "IN",
            "postal_code": "47834",
            "telephone_number": "812-442-2700",
            "fax_number": "812-442-2710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1206 E. NATIONAL AVENUE",
            "city": "BRAZIL",
            "state": "IN",
            "postal_code": "47834",
            "telephone_number": "812-442-2700",
            "fax_number": "812-442-2710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDMAN",
        "first_name": "SALLY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2014-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036-098644",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01042578A",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G74927",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000000602172",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "036098644",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036098644",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100381480",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Russell Harms DPM PC
• Sierra Sanders
• Shelley Anne Searing, PTA
• Michael R Shaw, D.C.
• Autumn Sheese, NP
• Christina E. Smith, OTR
• Jamie Beth Smith, PTA
• James David Spiller, MD
• St. Vincent Clay Hospital, Inc
• St. Vincent Clay Hospital, Inc.

• Emergency Medicine Physician in Brazil, IN
• Providers in Brazil, IN by specialty
• Emergency Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2014; 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.