Active NPI
Saundra M Bosche, RN/NP
- Family Nurse Practitioner
- Memphis, TN
National Provider Identifier
1699752311
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 140261
- Practice address
- 100 N Humphreys Blvd
Memphis, TN 38120-2146 - Phone
- (901) 683-0055
- Fax
- (901) 685-2969
- NPI assigned
- Dec 22, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | A810205 | MS | |
| Family Nurse Practitioner | 363LF0000X | 140261 | TN | Primary |
| Family Nurse Practitioner | 363LF0000X | 8428 | TN |
Addresses
Primary practice location
100 N Humphreys Blvd
Memphis, TN 38120-2146
Mailing address
100 N Humphreys Blvd
Memphis, TN 38120-2146
Phone (901) 683-0055
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02634202 | Medicaid | MS | |
| 3349346 | Medicaid | TN | |
| 83461 | Other | AR | BCBS AR |
| 4125245 | Other | TN | BCBS TN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8428 | TN | MD | Dentist |
| A810205 | MS | MD | Family Nurse Practitioner |
| 140261 | TN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mahmood a Siddiqui MD PC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- Copperhill, TN
- NPI 1427070523
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135209600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193184000000",
"number": "1699752311",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 N HUMPHREYS BLVD",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381202146",
"telephone_number": "901-683-0055",
"fax_number": "901-685-2969"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 N HUMPHREYS BLVD",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381202146",
"telephone_number": "901-683-0055",
"fax_number": "901-685-2969"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOSCHE",
"first_name": "SAUNDRA",
"middle_name": "M",
"credential": "RN/NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-12-22",
"last_updated": "2007-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MS",
"license": "A810205",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TN",
"license": "140261",
"primary": true
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TN",
"license": "8428",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02634202",
"state": "MS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3349346",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS AR",
"identifier": "83461",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS TN",
"identifier": "4125245",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.