Active NPI
Michael Edwin Bearb, M.D.
- Pain Medicine (Anesthesiology) Physician
- Jackson, TN
National Provider Identifier
1720022130
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Medicine (Anesthesiology) Physician
- License
- 24779
- Practice address
- 810 W Forest Ave
Jackson, TN 38301-3942 - Phone
- (731) 668-1853
- Fax
- (731) 664-7731
- NPI assigned
- Jun 15, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | 24779 | TN | Primary |
Addresses
Primary practice location
810 W Forest Ave
Jackson, TN 38301-3942
Mailing address
PO Box 3572
Jackson, TN 38303-3572
Phone (731) 668-1853
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3078790 | Medicaid | TN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jackson Anesthesiology Group, PLLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Anesthesiology Physician
- Jackson, TN
- NPI 1447591730
-
- Anesthesiology Physician
- Jackson, TN
- NPI 1770187734
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1294790400000",
"number": "1720022130",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3572",
"city": "JACKSON",
"state": "TN",
"postal_code": "383033572",
"telephone_number": "731-668-1853",
"fax_number": "731-664-7731"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "810 W FOREST AVE",
"city": "JACKSON",
"state": "TN",
"postal_code": "383013942",
"telephone_number": "731-668-1853",
"fax_number": "731-664-7731"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEARB",
"first_name": "MICHAEL",
"middle_name": "EDWIN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-15",
"last_updated": "2011-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "207LP2900X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pain Medicine",
"state": "TN",
"license": "24779",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3078790",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Jackson, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2011; 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.