Sara Robertson, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

56441 Issued in TN

Practice address

848 Adams Ave
Memphis, TN 38103

Phone

(901) 516-9294

NPI assigned

Apr 4, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://epicproxy.et1342.epichosted.com/APIProxyPRD/MLH/api/FHIR/R4
• Direct secure messaging: srobertson33416@mlh.direct-ci.com

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.

• Ut Lebonheur Pediatric Specialists, Inc.

  • Pediatrics Physician
  • Memphis, TN
  • NPI 1093024101
  Medicare reassignment
• Methodist Healthcare - Memphis Hospitals

  dba Le Bonheur Children's Hospital

  • Children's Hospital
  • Memphis, TN
  • NPI 1386709871
  NPD (past)

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

{
    "created_epoch": "1428105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530921600000",
    "number": "1568857613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "284 PALISADE ST",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381114528",
            "telephone_number": "513-293-4615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "848 ADAMS AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38103",
            "telephone_number": "901-516-9294"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "910 Madison Ave",
            "address_2": "Suite 1031",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381033403",
            "country_code": "US",
            "telephone_number": "901-287-6756",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "SARA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-04",
        "last_updated": "2018-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "TN",
            "license": "56441",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "56441",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09632858",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208208795",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Davis Robertson, PHARMD
• Jon H Robertson, MD
• Joy A Robertson
• Kenneth R Robertson, MD
• Madison Shepard Robertson, LPC-MHSP
• Shana Danielle Robertson, RN, FNP-BC
• Tiffanie Robertson
• Valerie Robertson, FNP
• Gaia E Robilio, MMFT
• Robin T Hobbs DDS PLLC (Aviation Pediatric Dental Associates)

• Pediatrics Physician in Memphis, TN
• Providers in Memphis, TN by specialty
• Pediatrics Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.