Peabody Family Care, PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PEABODY FAMILY CARE, PC

Practice address

1325 Eastmoreland Avenue
Suite 150
Memphis, TN 38104-3519

Phone

(901) 725-0648

Fax

(901) 725-1037

NPI assigned

Jun 5, 2006

Organization subpart

No

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

Authorized official

Name

Pam Alexander

Title

Administrator

Phone

(901) 756-5565

Specialties & licenses 1

Addresses

Other identifiers 4

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318377600000",
    "number": "1023057437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1000 DEPT 297",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381480001",
            "telephone_number": "901-725-0648",
            "fax_number": "901-725-1037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 EASTMORELAND AVENUE",
            "address_2": "SUITE 150",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381043519",
            "telephone_number": "901-725-0648",
            "fax_number": "901-725-1037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEABODY FAMILY CARE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-05",
        "last_updated": "2011-10-12",
        "status": "A",
        "authorized_official_last_name": "ALEXANDER",
        "authorized_official_first_name": "PAM",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "901-756-5565"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09015606",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3723978",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CG9962",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS AR-GROUP#",
            "identifier": "8P078",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pea Transit LLC
• Peace in My Home LLC
• Peace of Mind Adult Daycare Services, LLC
• Peace of Mind Home Care
• Peace of Mind Mental Health and Wellness Center LLC
• Peaceful Transitions in-Home Care Services Inc

• Family Medicine Physician in Memphis, TN
• Providers in Memphis, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.