Individual provider Active NPI

Hollis H Halford III, MD

  • Diagnostic Radiology Physician
  • Germantown, TN
National Provider Identifier
1043213945
Registry record updated Sep 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
12271 Issued in TN
Practice address
7695 Poplar Pike
Suite 101
Germantown, TN 38138-5947
Phone
(901) 685-2696
NPI assigned
May 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 12271 TN Primary

Addresses

Primary practice location

7695 Poplar Pike
Suite 101
Germantown, TN 38138-5947

Mailing address

8010 Stage Hills Blvd
Bartlett, TN 38133-4032
Phone (901) 291-2400

Other identifiers 1

IdentifierTypeStateIssuer
3177800MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100304000800 TN Practitioner - Diagnostic Radiology 7517057706 Reassigns benefits to 1 organization
I20130821000875 MS Practitioner - Diagnostic Radiology 7517057706 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Memphis Radiological, P.C. Diagnostic Radiology CurrentSince Jul 11, 2013 Accepting new patients
Memphis Radiological, P.C. Diagnostic Radiology CurrentSince Jan 1, 1986 Accepting new patients
Memphis Radiological, PC Past Accepting new patients

Locations

4250 Bethel Rd
Olive Branch, MS 38654
Phone (662) 932-9000

103 Halls Cv
Senatobia, MS 38668
Phone (662) 562-9003

7400 Airways Blvd
Southaven, MS 38671
Phone (662) 536-1000

7695 Poplar Pike
Ste 101
Memphis, TN 38138

7945 Wolf River Blvd
Memphis, TN 38138
Phone (901) 448-7000

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.

NPI Registry JSON

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315440000000",
    "number": "1043213945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8010 STAGE HILLS BLVD",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381334032",
            "telephone_number": "901-291-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7695 POPLAR PIKE",
            "address_2": "SUITE 101",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381385947",
            "telephone_number": "901-685-2696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALFORD",
        "first_name": "HOLLIS",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2011-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TN",
            "license": "12271",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3177800",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, TN

Sources for this page

Verify at the official NPI Registry.