NPIMap

Organization Active NPI

Pediatric Sedation Specialists, PC

  • Pediatric Emergency Medicine (Emergency Medicine) Physician
  • Memphis, TN
National Provider Identifier
1881686814
Registry record updated Aug 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Emergency Medicine) PhysicianTaxonomy code 207PP0204X
Legal business name
PEDIATRIC SEDATION SPECIALISTS, PC
Practice address
50 N Dunlap St
Memphis, TN 38103-2800
Phone
(901) 869-5708
NPI assigned
Aug 16, 2005
Last updated
Aug 1, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2007

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

Authorized official

Name
Dr. Martin I Herman, MDNPI 1346240777
Title
President
Phone
(901) 869-5708

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Emergency Medicine) Physician 207PP0204X Primary

Addresses

Primary practice location

50 N Dunlap St
Memphis, TN 38103-2800

Mailing address

PO Box 342767
Bartlett, TN 38184-2767
Phone (901) 291-2400

Other identifiers 1

IdentifierTypeStateIssuer
3723241MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040310000234 TN Part B Supplier - Clinic/Group Practice 6800784836 Receives reassigned benefits from 2 practitioners
Practice locations: Memphis, TN

National Provider Directory

National Provider Directory

Locations

5885 Airline Rd
Unit 992
Arlington, TN 38002

Practitioners & affiliated clinicians

Practitioners 31

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185926400000",
    "number": "1881686814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 342767",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381842767",
            "telephone_number": "901-291-2400",
            "fax_number": "901-379-0771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 N DUNLAP ST",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381032800",
            "telephone_number": "901-869-5708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC SEDATION SPECIALISTS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-16",
        "last_updated": "2007-08-01",
        "status": "A",
        "authorized_official_last_name": "HERMAN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "901-869-5708",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3723241",
            "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 Aug 1, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.