Organization Active NPI

Neil Bomar MD PLLC

  • Psychiatry Physician
  • Memphis, TN
National Provider Identifier
1053615229
Registry record updated Jan 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
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, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2011

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
3326060MedicaidTN

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.