NPIMap

Individual provider Active NPI

Jerome Seymour Tannenbaum, M.D., PH.D.

  • Nephrology Physician
  • Nashville, TN
National Provider Identifier
1346485638
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
MD9962 Issued in TN
Practice address
511 Union St
Suite 1800
Nashville, TN 37219-1733
Phone
(615) 467-0140
NPI assigned
Dec 16, 2008
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X MD9962 TN Primary

Addresses

Primary practice location

511 Union St
Suite 1800
Nashville, TN 37219-1733

Mailing address

511 Union St
Suite 1800
Nashville, TN 37219-1733
Phone (615) 467-0140

Other identifiers 1

IdentifierTypeStateIssuer
MD9962OtherTNMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160822000873 TN Practitioner - Nephrology 4284541087 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Vanderbilt University School of Medicine, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
National Tele-Nephrology Associates, PCGroup PAC ID 5496040065, 3 clinicians

Practice addresses (Care Compare)

511 Union St
Suite 1800
Nashville, TN 37219-2509
Phone (855) 350-7365

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
MD9962TNMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
National Tele-Nephrology Associates PC Nephrology CurrentSince Jul 25, 2016 Accepting new patients
Sanderling Renal Services-USA,LLC Past Accepting new patients
Sanderling Renal Services of Holdenville PastSince Nov 30, 2016 Accepting new patients
Isd Renal Inc PastSince Jul 2, 2001 Accepting new patients
Isd Canton LLC PastSince Apr 30, 2003 Accepting new patients
SRS-Crescent City, LLC PastSince Dec 20, 2016 Accepting new patients
SRS-la Habra PastSince Jan 9, 2023 Accepting new patients
SRS-Los Nietos PastSince Nov 1, 2023 Accepting new patients
SRS-la Mirada LLC PastSince Jan 9, 2023 Accepting new patients
SRS-Nashville HH LLC Past Accepting new patients
SRS-Weber Valley, LLC PastSince Nov 1, 2021 Accepting new patients
SRS - Ramona LLC PastSince Jun 10, 2016 Accepting new patients
SRS-Provo, LLC PastSince Nov 1, 2021 Accepting new patients
SRS- Kirksville LLC PastSince Dec 1, 2013 Accepting new patients
SRS-Watsonville, LLC PastSince Dec 18, 2018 Accepting new patients
SRS-San Diego LLC PastSince Jun 4, 2018 Accepting new patients
SRS-Thousand Oaks PastSince Nov 1, 2023 Accepting new patients
SRS - Tehachapi LLC PastSince Sep 4, 2014 Accepting new patients

Locations

511 Union St
Ste 1800
Nashville, TN 37219
Phone (615) 777-8201

Interoperability endpoints

  • Direct secure messaging: jerome.tannenbaum.1@20919.direct.athenahealth.com

Organizations & group practices 30

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.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1229385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1346485638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 UNION ST",
            "address_2": "SUITE 1800",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372191733",
            "telephone_number": "615-467-0140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 UNION ST",
            "address_2": "SUITE 1800",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372191733",
            "telephone_number": "615-467-0140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNENBAUM",
        "first_name": "JEROME",
        "middle_name": "SEYMOUR",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-12-16",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TN",
            "license": "MD9962",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "MD9962",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

Verify at the official NPI Registry.