Jennifer Lea Sauceman, M.D.

Key facts

NPI

1992930846

Entity type

Individual (NPI type 1)

Primary specialty

Pediatrics Physician 208000000X

License

MD51151 (TN)

Practice address

1829 Crowe LN
Newport, TN 37821-7264

Phone

(423) 623-0653

NPI assigned

May 21, 2009

Sex

Female

Sole proprietor

No

Organizations & group practices 3

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.

• Newport Pediatrics, P.C. Pediatrics Physician · Newport, TN · NPI 1467678706
  Medicare reassignment NPD PEDIATRICS · TN
• Wake Forest University Health Sciences Multi-Specialty Clinic/Center · Winston Salem, NC · NPI 1003803032
  NPD (past)
• Wake Forest University Health Sciences Multi-Specialty Clinic/Center · Lexington, NC · NPI 1639454499
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

Practice roles

Locations

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 22, 2016.

{
    "created_epoch": "1242864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456099200000",
    "number": "1992930846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1829 CROWE LN",
            "city": "NEWPORT",
            "state": "TN",
            "postal_code": "378217264",
            "telephone_number": "423-623-0653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1829 CROWE LN",
            "city": "NEWPORT",
            "state": "TN",
            "postal_code": "378217264",
            "telephone_number": "423-623-0653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAUCEMAN",
        "first_name": "JENNIFER",
        "middle_name": "LEA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-21",
        "last_updated": "2016-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2012-00689",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "MD51151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5921176",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q005159",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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All providers in Newport, TN · Pediatrics Physician in Tennessee