Individual provider Active NPI

Fariborz A Yaghini, NP

  • Family Nurse Practitioner
  • Memphis, TN
National Provider Identifier
1073022133
Registry record updated Sep 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
23145 Issued in TN
Practice address
1325 Eastmoreland Ave Ste 365
Memphis, TN 38104-7542
Phone
(901) 272-6030
Fax
(901) 516-8450
NPI assigned
Sep 21, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 23145 TN Primary

Addresses

Primary practice location

1325 Eastmoreland Ave Ste 365
Memphis, TN 38104-7542

Mailing address

P O Box 1000 Dept 960
Memphis, TN 38148-0001
Phone (901) 763-0200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180112000518 TN Practitioner - Nurse Practitioner 9032478334 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Specialty Physician Group LLCGroup PAC ID 9537291323, 101 clinicians

Practice addresses (Care Compare)

1325 Eastmoreland Ave
Suite 365
Memphis, TN 38104-7542
Phone (901) 272-6030

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
23145TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Specialty Physician Group LLC Family CurrentSince Oct 23, 2017 Accepting new patients

Locations

7460 Wolf River Blvd
#200
Germantown, TN 38138

1325 Eastmoreland Ave
Ste 365
Memphis, TN 38104
Phone (901) 272-6018

7460 Wolf River Blvd
Memphis, TN 38138
Phone (901) 516-6792

Interoperability endpoints

  • Direct secure messaging: fyaghini26228@mlh.direct-ci.com

Organizations & group practices 1

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1505952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505952000000",
    "number": "1073022133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 1000 DEPT 960",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381480001",
            "telephone_number": "901-763-0200",
            "fax_number": "901-260-1704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 EASTMORELAND AVE STE 365",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381047542",
            "telephone_number": "901-272-6030",
            "fax_number": "901-516-8450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAGHINI",
        "first_name": "FARIBORZ",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-21",
        "last_updated": "2017-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "23145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.