Organization Active NPI

Memphis Cardiac Care Center, PLLC

  • Clinical Cardiac Electrophysiology Physician
  • Memphis, TN
National Provider Identifier
1053362749
Registry record updated Dec 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
MD0000035150 Issued in TN
Legal business name
MEMPHIS CARDIAC CARE CENTER, PLLC
Practice address
1325 Eastmoreland Ave
Suite 440
Memphis, TN 38104-3519
Phone
(901) 722-8884
Fax
(901) 276-1436
NPI assigned
May 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2007

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

Authorized official

Name
Sunil Jha, M.D.NPI 1639122054
Title
President
Phone
(901) 722-8884

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Cardiac Electrophysiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0001X MD0000035150 TN Primary

Addresses

Primary practice location

1325 Eastmoreland Ave
Suite 440
Memphis, TN 38104-3519

Mailing address

PO Box 381588
Germantown, TN 38183-1588
Phone (901) 722-8884

Other identifiers 2

IdentifierTypeStateIssuer
3863065MedicaidTN
00124374MedicaidMS

National Provider Directory

National Provider Directory

Locations

1211 Union Ave
Ste 310
Memphis, TN 38104
Phone (901) 309-1777

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196899200000",
    "number": "1053362749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 381588",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381831588",
            "telephone_number": "901-722-8884",
            "fax_number": "901-276-1436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 EASTMORELAND AVE",
            "address_2": "SUITE 440",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381043519",
            "telephone_number": "901-722-8884",
            "fax_number": "901-276-1436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMPHIS CARDIAC CARE CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-15",
        "last_updated": "2007-12-06",
        "status": "A",
        "authorized_official_last_name": "JHA",
        "authorized_official_first_name": "SUNIL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "901-722-8884",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "TN",
            "license": "MD0000035150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3863065",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00124374",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2007; 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.