Active NPI
Jeffrey Sands Lodge, MD
- Obstetrics & Gynecology Physician
- Brentwood, TN
National Provider Identifier
1407931504
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- MD0000026575
- Practice address
- 1804 Williamson CT
Suite 208
Brentwood, TN 37027-8170 - Phone
- (615) 690-6600
- Fax
- (615) 690-6604
- NPI assigned
- Oct 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | MD0000026575 | TN | Primary |
Addresses
Primary practice location
1804 Williamson CT
Suite 208
Brentwood, TN 37027-8170
Mailing address
1804 Williamson CT
Suite 208
Brentwood, TN 37027-8170
Phone (615) 690-6600
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4096252 | Other | TN | TENNCARE SELECT |
| 4096252 | Other | TN | BLUE CROSS OF TN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jul 1, 2018 through Jul 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD0000026575 | TN | MD | Obstetrics & Gynecology Physician |
| 26575 | TN | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tennessee Women'S Care, PC | Obstetrics & Gynecology | Past | Accepting new patients |
| J. Rowland MD, LLC | Obstetrics & Gynecology | Past | Accepting new patients |
Interoperability endpoints
- jslodgemd@coolspringsmd.gwaydirect.com
Organizations & group practices 2
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.
-
- Obstetrics & Gynecology Physician
- Chattanooga, TN
- NPI 1730566332
-
- Obstetrics & Gynecology Physician
- Nashville, TN
- NPI 1578584199
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1306886400000",
"number": "1407931504",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1804 WILLIAMSON CT",
"address_2": "SUITE 208",
"city": "BRENTWOOD",
"state": "TN",
"postal_code": "370278170",
"telephone_number": "615-690-6600",
"fax_number": "615-690-6604"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1804 WILLIAMSON CT",
"address_2": "SUITE 208",
"city": "BRENTWOOD",
"state": "TN",
"postal_code": "370278170",
"telephone_number": "615-690-6600",
"fax_number": "615-690-6604"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LODGE",
"first_name": "JEFFREY",
"middle_name": "SANDS",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-26",
"last_updated": "2011-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "TN",
"license": "MD0000026575",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TENNCARE SELECT",
"identifier": "4096252",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS OF TN",
"identifier": "4096252",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Brentwood, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.