Ageless Men's Health, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

44D1072470 Issued in TN

Legal business name

AGELESS MEN'S HEALTH, LLC

Practice address

4515 Poplar Ave Ste 131
Memphis, TN 38117-7520

Phone

(901) 507-8040

NPI assigned

Dec 3, 2007

Last updated

Nov 11, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Amanda Wilkinson

Title

Business Operations Director

Phone

(702) 818-0446

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 48

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.

• Nicole Dunlap, FNP

  • Family Nurse Practitioner
  • Memphis, TN
  • NPI 1063701969
  NPD
• Brooke Amanda Helms, P.A.

  • Physician Assistant
  • Germantown, TN
  • NPI 1093925950
  NPD
• Tracy Lytle Huffstatler, APN, RN, ACNP-BC

  • Nurse Practitioner
  • Deforest, WI
  • NPI 1538305800
  NPD
• Victoria May Johnson, NP-C

  • Family Nurse Practitioner
  • Germantown, TN
  • NPI 1417661570
  NPD (past)
• Charlotte Joure Knight, APRN

  • Family Nurse Practitioner
  • Germantown, TN
  • NPI 1427521053
  NPD (past)
• Chris Edens Marcellus, PA

  • Physician Assistant
  • Memphis, TN
  • NPI 1336871904
  NPD (past)
• Angela Paige McKnight, FNP-BC

  • Family Nurse Practitioner
  • Cordova, TN
  • NPI 1497644306
  NPD (past)
• Laura Marie Stiles, MS, PA-C

  • Physician Assistant
  • Memphis, TN
  • NPI 1811412612
  NPD (past)
• Corrinne Michele Andresen, MSN, FNP-C

  • Nurse Practitioner
  • Downers Grove, IL
  • NPI 1558252841
  NPD (past)
• Carleigh Ballard-Sayonh, MSN, BSN, RN

  • Family Nurse Practitioner
  • Huntsville, AL
  • NPI 1528688819
  NPD (past)
• Nathaniel Levi Bump, FNP-C

  • Family Nurse Practitioner
  • Southaven, MS
  • NPI 1003449398
  NPD (past)
• Stacy Cazeau, FNP-BC

  • Family Nurse Practitioner
  • Marriott Slaterville, UT
  • NPI 1871259184
  NPD (past)

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

{
    "created_epoch": "1196640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731283200000",
    "number": "1003098997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4515 POPLAR AVE STE 131",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381177520",
            "telephone_number": "901-507-8040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4515 POPLAR AVE STE 131",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381177520",
            "telephone_number": "901-507-8040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "530 Oak Court Dr",
            "address_2": "Suite 125",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381173726",
            "country_code": "US",
            "telephone_number": "901-507-8040",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9067 Poplar Ave Ste 109",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "TN",
            "postal_code": "381387851",
            "country_code": "US",
            "telephone_number": "901-522-6745",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AGELESS MEN'S HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-03",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A",
        "authorized_official_last_name": "WILKINSON",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "BUSINESS OPERATIONS DIRECTOR",
        "authorized_official_telephone_number": "702-818-0446"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "TN",
            "license": "44D1072470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Memphis, TN
• Providers in Memphis, TN by specialty
• Clinical Medical Laboratory in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.