Organization Active NPI

Bioserenity USA Inc.

  • Sleep Medicine (Psychiatry & Neurology) Physician
  • Macon, GA
National Provider Identifier
1518976554
Registry record updated May 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084S0012X
Legal business name
BIOSERENITY USA INC.
Practice address
770 Hemlock St
Suite C
Macon, GA 31201
Phone
(478) 745-9050
Fax
(478) 745-5125
NPI assigned
Aug 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2022

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

Authorized official

Name
Janice Shock
Title
Evp Clinical Operations
Phone
(214) 532-3757

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Medicine (Psychiatry & Neurology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084S0012X Primary
Sleep Disorder Diagnostic Clinic/Center 261QS1200X

Addresses

Primary practice location

770 Hemlock St
Suite C
Macon, GA 31201

Mailing address

99 Rosewood Dr Ste 245
Danvers, MA 01923-4537
Phone (978) 536-7400

Other identifiers 3

IdentifierTypeStateIssuer
905532OtherBLUE CROSS
2860022OtherAETNA HMO
7618325OtherAETNA PPO

Other names 1

  • SleepMed, Inc. Doing business as

National Provider Directory

National Provider Directory

Locations

770 Hemlock St
Ste C
Macon, GA 31201
Phone (478) 745-9050

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652140800000",
    "number": "1518976554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 ROSEWOOD DR STE 245",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019234537",
            "telephone_number": "978-536-7400",
            "fax_number": "978-536-6332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 HEMLOCK ST",
            "address_2": "SUITE C",
            "city": "MACON",
            "state": "GA",
            "postal_code": "31201",
            "telephone_number": "478-745-9050",
            "fax_number": "478-745-5125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIOSERENITY USA INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-07",
        "last_updated": "2022-05-10",
        "certification_date": "2022-05-10",
        "status": "A",
        "authorized_official_last_name": "SHOCK",
        "authorized_official_first_name": "JANICE",
        "authorized_official_title_or_position": "EVP  CLINICAL OPERATIONS",
        "authorized_official_telephone_number": "214-532-3757"
    },
    "taxonomies": [
        {
            "code": "2084S0012X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QS1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Sleep Disorder Diagnostic",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "905532",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "2860022",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "7618325",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SleepMed, Inc.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SleepMed, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2022; 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.