Active NPI
Phillip A Pedigo, M.D.
- Surgery Physician
- Germantown, TN
National Provider Identifier
1952312431
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 3269
- Practice address
- 2100 Exeter Rd
Germantown, TN 38138-3922 - Phone
- (901) 757-3414
- Fax
- (901) 757-3416
- NPI assigned
- Aug 10, 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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 3269 | TN | Primary |
Addresses
Primary practice location
2100 Exeter Rd
Germantown, TN 38138-3922
Mailing address
2100 Exeter Rd
Germantown, TN 38138-3922
Phone (901) 757-3414
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1507222 | Medicaid | TN | |
| 4168297 | 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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3269 | TN | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baptist Memorial Medical Group Inc | Surgery | Past | Accepting new patients |
| Baptist Memorial Medical Group Inc | 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.
-
- Community/Retail Pharmacy
- Memphis, TN
- NPI 1841006129
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1242086400000",
"number": "1952312431",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2100 EXETER RD",
"city": "GERMANTOWN",
"state": "TN",
"postal_code": "381383922",
"telephone_number": "901-757-3414",
"fax_number": "901-757-3416"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 EXETER RD",
"city": "GERMANTOWN",
"state": "TN",
"postal_code": "381383922",
"telephone_number": "901-757-3414",
"fax_number": "901-757-3416"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEDIGO",
"first_name": "PHILLIP",
"middle_name": "A",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-10",
"last_updated": "2009-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "TN",
"license": "3269",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1507222",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS TN",
"identifier": "4168297",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Germantown, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.