Active NPI
Neil Bomar MD PLLC
- Psychiatry Physician
- Memphis, TN
National Provider Identifier
1053615229
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- Legal business name
- NEIL BOMAR MD PLLC
- Practice address
- 6750 Poplar Ave
620
Memphis, TN 38138-7438 - Phone
- (901) 755-9908
- Fax
- (901) 309-8784
- NPI assigned
- Jan 3, 2011
- Last updated
- Jan 3, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Lois E Horton, MBA
- Title
- Practice Manager
- Phone
- (901) 737-1992
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | Primary |
Addresses
Primary practice location
6750 Poplar Ave
620
Memphis, TN 38138-7438
Mailing address
6750 Poplar Ave
620
Memphis, TN 38138-7438
Phone (901) 755-9908
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3326060 | Medicaid | TN |
National Provider Directory
National Provider DirectoryLocations
6750 Poplar Ave
Ste 620
Memphis, TN 38138
Phone (901) 255-3030
Practitioners & affiliated clinicians
Practitioners 1
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.
-
- Psychiatry Physician
- Cumberland Furnace, TN
- NPI 1922029586
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1294012800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1294012800000",
"number": "1053615229",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6750 POPLAR AVE",
"address_2": "620",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381387438",
"telephone_number": "901-755-9908",
"fax_number": "901-309-8784"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6750 POPLAR AVE",
"address_2": "620",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381387438",
"telephone_number": "901-755-9908",
"fax_number": "901-309-8784"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NEIL BOMAR MD PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2011-01-03",
"last_updated": "2011-01-03",
"status": "A",
"authorized_official_last_name": "HORTON",
"authorized_official_first_name": "LOIS",
"authorized_official_middle_name": "E",
"authorized_official_title_or_position": "PRACTICE MANAGER",
"authorized_official_telephone_number": "901-737-1992",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "MBA"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3326060",
"state": "TN"
}
],
"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 Jan 3, 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.