NPIMap

Organization Active NPI

Physician Services of Cleveland, PC

  • Emergency Medicine Physician
  • Cleveland, TN
National Provider Identifier
1457378341
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
PHYSICIAN SERVICES OF CLEVELAND, PC
Practice address
2650 Executive Park NW
Suite 5
Cleveland, TN 37312-2746
Phone
(423) 479-9679
Fax
(423) 559-9046
NPI assigned
Jul 16, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. David E. Sink Sr.
Title
Administrator
Phone
(423) 479-9679

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207P00000X Primary

Addresses

Primary practice location

2650 Executive Park NW
Suite 5
Cleveland, TN 37312-2746

Mailing address

2650 Executive Park NW
Suite 5
Cleveland, TN 37312-2746
Phone (423) 479-9679

National Provider Directory

National Provider Directory

Locations

2650 Executive Park NW
Ste 5
Cleveland, TN 37312
Phone (423) 479-8775

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1457378341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 EXECUTIVE PARK NW",
            "address_2": "SUITE 5",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373122746",
            "telephone_number": "423-479-9679",
            "fax_number": "423-559-9046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 EXECUTIVE PARK NW",
            "address_2": "SUITE 5",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373122746",
            "telephone_number": "423-479-9679",
            "fax_number": "423-559-9046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIAN SERVICES OF CLEVELAND, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SINK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "423-479-9679",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, TN

Sources for this page

  • 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.