Individual provider Active NPI

Sandra W Cohen, M.D.

  • Internal Medicine Physician
  • Cordova, TN
National Provider Identifier
1275569055
Registry record updated Jun 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
44372 Issued in TN
Practice address
57 Germantown CT
Suite 100
Cordova, TN 38018-7273
Phone
(901) 758-7888
Fax
(901) 266-6445
NPI assigned
Jun 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 147466 NY
Internal Medicine Physician 207R00000X 44372 TN Primary

Addresses

Primary practice location

57 Germantown CT
Suite 100
Cordova, TN 38018-7273

Mailing address

PO Box 1000
Dept # 457
Memphis, TN 38148-0001
Phone (901) 758-7888

Other practice location 1

8040 Wolf River Blvd Ste 102
Germantown, TN 38138-1773
Phone (901) 725-8606

Other identifiers 5

IdentifierTypeStateIssuer
1513556MedicaidTN
P01246356OtherTNRAILROAD MEDICARE
4355484OtherTNBCBS
177839001MedicaidAR
00728228MedicaidMS

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

State licenses

LicenseStateTypeSpecialty
44372TNMDInternal Medicine Physician
147466NYMDGeriatric Medicine (Internal Medicine) Physician

NPI Registry JSON

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623974400000",
    "number": "1275569055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1000",
            "address_2": "DEPT # 457",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381480001",
            "telephone_number": "901-758-7888",
            "fax_number": "901-266-6445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 GERMANTOWN CT",
            "address_2": "SUITE 100",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380187273",
            "telephone_number": "901-758-7888",
            "fax_number": "901-266-6445"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8040 Wolf River Blvd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "TN",
            "postal_code": "381381773",
            "country_code": "US",
            "telephone_number": "901-725-8606",
            "fax_number": "901-759-9254",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COHEN",
        "first_name": "SANDRA",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-24",
        "last_updated": "2021-06-18",
        "certification_date": "2021-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NY",
            "license": "147466",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "44372",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1513556",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01246356",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4355484",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "177839001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00728228",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cordova, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2021; 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.