Active NPI
Brandon Davis Conaway
- Critical Care Pharmacist
- Memphis, TN
National Provider Identifier
1073203410
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Pharmacist
- License
- 45291
- Practice address
- 877 Jefferson Ave
Memphis, TN 38103-2807 - Phone
- (901) 545-7100
- NPI assigned
- May 9, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Pharmacist | 1835C0205X | 45291 | TN | Primary |
Addresses
Primary practice location
877 Jefferson Ave
Memphis, TN 38103-2807
Mailing address
369 Winding River Cir Apt 206
Memphis, TN 38120-2900
Phone (731) 695-5844
Other practice location 1
1030 Jefferson Ave
Memphis, TN 38104-2127
Phone (901) 523-8990
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 45291 | TN | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1683590400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1683590400000",
"number": "1073203410",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "369 WINDING RIVER CIR APT 206",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381202900",
"telephone_number": "731-695-5844"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "877 JEFFERSON AVE",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381032807",
"telephone_number": "901-545-7100"
}
],
"practiceLocations": [
{
"address_1": "1030 Jefferson Ave",
"address_purpose": "LOCATION",
"city": "Memphis",
"state": "TN",
"postal_code": "381042127",
"country_code": "US",
"telephone_number": "901-523-8990",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CONAWAY",
"first_name": "BRANDON",
"middle_name": "DAVIS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-05-09",
"last_updated": "2023-05-09",
"certification_date": "2023-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "1835C0205X",
"taxonomy_group": "",
"desc": "Pharmacist, Critical Care",
"state": "TN",
"license": "45291",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Memphis, TN
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- Concentra Health Services, Inc.
- Concentra Laboratory LLC
- Concentra Laboratory LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.