Somerville Emergency Services, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

SOMERVILLE EMERGENCY SERVICES, LLC

Practice address

214 Lakeview Rd
Somerville, TN 38068-9737

Phone

(901) 465-3594

NPI assigned

May 17, 2006

Organization subpart

No

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

Authorized official

Name

Eugene Dauchert

Title

Authorized Official

Phone

(919) 768-4392

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1225080997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 ATLANTIC BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322118768",
            "telephone_number": "904-805-1300",
            "fax_number": "904-805-1456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 LAKEVIEW RD",
            "city": "SOMERVILLE",
            "state": "TN",
            "postal_code": "380689737",
            "telephone_number": "901-465-3594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOMERVILLE EMERGENCY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DAUCHERT",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "919-768-4392"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3727937",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE GROUP NUMBER",
            "identifier": "56231441",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stacey Miller Shands, RN
• Sheila Elizabeth Shiers, O.T.
• Stephanie Denise Smith, FNP
• Somerville Dental Associates
• Somerville Dialysis Center LLC (Somerville Dialysis)
• Somerville Emergency Services, LLC
• Somerville Medical Clinic,Inc
• Stacie Sowell, FNP-C
• SS Holdings, LLC
• State of Tennessee (Fayette County Health Department)

• Internal Medicine Physician in Somerville, TN
• Providers in Somerville, TN by specialty
• Internal Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.