NPIMap

Organization Active NPI

Memphis and Shelby County Health Dept.

  • Family Medicine Physician
  • Memphis, TN
National Provider Identifier
1073514055
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
36735 Issued in TN
Legal business name
MEMPHIS AND SHELBY COUNTY HEALTH DEPT.
Practice address
1064 Breedlove St
Memphis, TN 38107-2805
Phone
(901) 515-5400
Fax
(901) 526-1208
NPI assigned
Aug 2, 2005
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Mr. Clayton Moore
Title
Controller
Phone
(901) 272-0387

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 36735 TN Primary
Internal Medicine Physician 207R00000X 26170 TN
Pediatrics Physician 208000000X 20023 TN

Addresses

Primary practice location

1064 Breedlove St
Memphis, TN 38107-2805

Mailing address

877 Jefferson Ave
5TH Floor Adams Pavilion
Memphis, TN 38103-2807
Phone (901) 272-0387

Other names 1

  • Shelby County Government Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Memphis Shelby County H6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1064 Breedlove St
Memphis, TN 38107
Phone (901) 515-5400

451 Dr Ml King Jr Ave
Memphis, TN 38126
Phone (901) 526-7285

Practitioners & affiliated clinicians

Practitioners 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1073514055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "877 JEFFERSON AVE",
            "address_2": "5TH FLOOR ADAMS PAVILION",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381032807",
            "telephone_number": "901-272-0387",
            "fax_number": "901-272-0292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1064 BREEDLOVE ST",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381072805",
            "telephone_number": "901-515-5400",
            "fax_number": "901-526-1208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMPHIS AND SHELBY COUNTY HEALTH DEPT.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-02",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "CLAYTON",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "901-272-0387",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "36735",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "26170",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "20023",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shelby County Government",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Sep 11, 2025; 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.