NPIMap

Individual provider Active NPI

Eric J Homberg, MD

  • Pain Medicine (Anesthesiology) Physician
  • Jackson, TN
National Provider Identifier
1548304835
Registry record updated Nov 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
21764 Issued in TN
Practice address
24 Physicians Dr
Jackson, TN 38305-2070
Phone
(731) 661-9825
Fax
(731) 668-6757
NPI assigned
Feb 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 21764 TN Primary
Anesthesiology Physician 207L00000X MD21764 TN

Addresses

Primary practice location

24 Physicians Dr
Jackson, TN 38305-2070

Mailing address

24 Physicians Dr
Jackson, TN 38305-2070
Phone (731) 661-9825

Other identifiers 1

IdentifierTypeStateIssuer
1519639MedicaidTN

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
I20101104000446 TN Practitioner - AnesthesiologyPractitioner - Pain Management 9830098706 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pain Management
Education
University of Tennessee, HSC, College of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
West Tennessee Bone and Joint Clinic PCGroup PAC ID 7517940182, 64 clinicians

Practice addresses (Care Compare)

50 Capital Ave
Jackson, TN 38305-5507
Phone (731) 661-9825

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.05 of 100Reported as group
Promoting interoperability
98
Improvement activities
40
Cost
73.85

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6529TNMDClinical Social Worker
MD21764TNMDAnesthesiology Physician
21764TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
West Tennessee Bone and Joint Clinic PC CurrentSince Jan 14, 2014 Accepting new patients
Jackson Anesthesia & Perioperative Consultants P C Anesthesiology Past Accepting new patients
Jackson Interventional Pain Center LLC Pain Medicine Past Accepting new patients

Locations

24 Physicians Dr
Jackson, TN 38305
Phone (731) 661-9825

50 Capital Ave
Jackson, TN 38305
Phone (731) 661-9825

Interoperability endpoints

  • Direct secure messaging: eric.homberg.1@3533.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446422400000",
    "number": "1548304835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 PHYSICIANS DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052070",
            "telephone_number": "731-661-9825",
            "fax_number": "731-668-6757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 PHYSICIANS DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052070",
            "telephone_number": "731-661-9825",
            "fax_number": "731-668-6757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOMBERG",
        "first_name": "ERIC",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-19",
        "last_updated": "2015-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "TN",
            "license": "21764",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TN",
            "license": "MD21764",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1519639",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.