Your ENT, PLLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

15081 Issued in TN

Legal business name

YOUR ENT, PLLC

Practice address

2028 W Poplar Ave
Suite 112
Collierville, TN 38017-0618

Phone

(901) 861-2526

Fax

(901) 861-2527

NPI assigned

Nov 7, 2016

Organization subpart

No

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

Authorized official

Name

Mrs. Kathryn Lenderman King, FNP

Title

Owner

Phone

(901) 861-2526

Specialties & licenses 1

Addresses

Other identifiers 8

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/15475/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1478476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480377600000",
    "number": "1023550100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2028 W POPLAR AVE",
            "address_2": "SUITE 112",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380170618",
            "telephone_number": "901-861-2526",
            "fax_number": "901-861-2527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2028 W POPLAR AVE",
            "address_2": "SUITE 112",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380170618",
            "telephone_number": "901-861-2526",
            "fax_number": "901-861-2527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUR ENT, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-07",
        "last_updated": "2016-11-29",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_middle_name": "LENDERMAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "901-861-2526",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "TN",
            "license": "15081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1519558",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00873707",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01434865",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "5073174",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "183493758",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "4270955",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1740591437",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "3196332",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Natalie Wyatt, AU.D., FAAA, CCC-A
• Rachel Sharp Wyatt, O.D.
• Moesha Yancey
• Seth L Yoser, M.D.
• Charles Edmund Young Jr., D.D.S.
• Your Tennessee Counselor, PLLC
• Catherine A Zanskas, LPC-MHSP

• Medical Specialty Clinic/Center in Collierville, TN
• Providers in Collierville, TN by specialty
• Medical Specialty Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2016; 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.