NPIMap

Organization Active NPI

Mid-South Imaging & Therapeutics, P.a.

  • Diagnostic Radiology Physician
  • Germantown, TN
National Provider Identifier
1043260763
Registry record updated Oct 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
MID-SOUTH IMAGING & THERAPEUTICS, P.A.
Practice address
7600 Wolf River Blvd.
#200
Germantown, TN 38138
Phone
(901) 747-1000
Fax
(901) 747-1001
NPI assigned
May 11, 2006
Last updated
Oct 17, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2026

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

Authorized official

Name
Dr. John A Ellzey, MDNPI 1447365846
Title
President
Phone
(901) 473-6406

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X
Specialist 174400000X
Diagnostic Radiology Physician 2085R0202X Primary

Addresses

Primary practice location

7600 Wolf River Blvd.
#200
Germantown, TN 38138

Mailing address

PO Box 5083
Memphis, TN 38101-5083
Phone (901) 383-8860

Other practice location 1

555 Perkins Ext Ste 100&200
Memphis, TN 38117-4410
Phone (901) 747-1000

Other practice location 2

55 Physicians Ln
Southaven, MS 38671-9569
Phone (901) 747-1007

Other practice location 3

6286 Briarcrest Ave Ste 300
Memphis, TN 38120-4023
Phone (901) 747-1007

Other identifiers 6

IdentifierTypeStateIssuer
107365002MedicaidAR
3373325MedicaidTN
0022687OtherTNGROUP TN BCBS #
09013816MedicaidMS
508212206MedicaidMO
86018OtherARGROUP AR BCBS #

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://cpiapigateway.cms.gov/api/esmdf/ext/v1/fhir/Practitioner/ Other Management Services Network, LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS, AR3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040706000767 TN Part B Supplier - Clinic/Group Practice 9133106396 Receives reassigned benefits from 95 practitioners
Practice locations: Medina, TN; Memphis, TN; Union City, TN; Lexington, TN; Brownsville, TN; Collierville, TN; Cordova, TN; Covington, TN…
O20041007000146 MS Part B Supplier - Clinic/Group Practice 9133106396 Receives reassigned benefits from 81 practitioners
Practice locations: Olive Branch, MS; Southaven, MS; Oxford, MS; Horn Lake, MS; Booneville, MS
O20170124002448 AR Part B Supplier - Clinic/Group Practice 9133106396 Receives reassigned benefits from 69 practitioners
Practice locations: Jonesboro, AR; West Memphis, AR

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

9075 Sandidge Center Cv
Olive Branch, MS 38654
Phone (662) 895-4949

670 N Germantown Pkwy
Ste 18
Cordova, TN 38018
Phone (901) 753-7686

2705 Appling Rd
Ste 202
Memphis, TN 38133

555 Perkins Ext
Ste 100
Memphis, TN 38117

6305 Humphreys Blvd
Ste 205
Memphis, TN 38120
Phone (901) 747-1000

7715 Wolf River Blvd
Memphis, TN 38138
Phone (901) 328-6031

8040 Wolf River Blvd
Ste 200
Memphis, TN 38138
Phone (901) 726-0200

Practitioners & affiliated clinicians

Practitioners 150

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.

View all 150

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1792195200000",
    "number": "1043260763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5083",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381015083",
            "telephone_number": "901-383-8860",
            "fax_number": "901-383-8985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 WOLF RIVER BLVD.",
            "address_2": "#200",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "38138",
            "telephone_number": "901-747-1000",
            "fax_number": "901-747-1001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "555 Perkins Ext Ste 100&200",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381174410",
            "country_code": "US",
            "telephone_number": "901-747-1000",
            "fax_number": "901-747-1001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "55 Physicians Ln",
            "address_purpose": "LOCATION",
            "city": "Southaven",
            "state": "MS",
            "postal_code": "386719569",
            "country_code": "US",
            "telephone_number": "901-747-1007",
            "fax_number": "662-996-2214",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6286 Briarcrest Ave Ste 300",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381204023",
            "country_code": "US",
            "telephone_number": "901-747-1007",
            "fax_number": "901-531-7199",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MID-SOUTH IMAGING & THERAPEUTICS, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-11",
        "last_updated": "2026-10-17",
        "certification_date": "2026-10-17",
        "status": "A",
        "authorized_official_last_name": "ELLZEY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "901-473-6406",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "107365002",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3373325",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP TN BCBS #",
            "identifier": "0022687",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09013816",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "508212206",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP AR BCBS #",
            "identifier": "86018",
            "state": "AR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://cpiapigateway.cms.gov/api/esmdf/ext/v1/fhir/Practitioner/",
            "affiliation": "Y",
            "endpointDescription": "urn:oid:2.16.840.1.113883.3.1036.1",
            "affiliationName": "Management Services Network, LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2357 Warm Springs RD ste 400",
            "city": "Columbus",
            "state": "GA",
            "country_code": "US",
            "postal_code": "319046874",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Germantown, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.