NPIMap

Organization Active NPI

Mid-South Pulmonary Specialists PC

  • Critical Care Medicine (Internal Medicine) Physician
  • Memphis, TN
National Provider Identifier
1073592275
Registry record updated Nov 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
Legal business name
MID-SOUTH PULMONARY SPECIALISTS PC
Practice address
5050 Poplar Ave
Suite 800
Memphis, TN 38157-0101
Phone
(901) 276-2662
Fax
(901) 274-1871
NPI assigned
Jan 16, 2006
Last updated
Nov 12, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2019

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

Authorized official

Name
Mrs. Kimberly Weis Avery, JD
Title
Administrator
Phone
(901) 333-8443

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RC0200X Primary
Pulmonary Disease PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RP1001X
Sleep Medicine (Internal Medicine) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RS0012X
Pediatric Sleep Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2080S0012X

Addresses

Primary practice location

5050 Poplar Ave
Suite 800
Memphis, TN 38157-0101

Mailing address

5050 Poplar Ave
Suite 800
Memphis, TN 38157-0101
Phone (901) 276-2662

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040415000557 TN Part B Supplier - Clinic/Group Practice 5092700518 Receives reassigned benefits from 50 practitioners
Practice locations: Memphis, TN
O20110906000578 MS Part B Supplier - Clinic/Group Practice 5092700518 Receives reassigned benefits from 9 practitioners
Practice locations: Olive Branch, MS

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D1037149Mid-South Pulmonary Specialists PC5050 Poplar Avenue Suite #800, Memphis, TN 38157Certificate of waiverNov 12, 2026

National Provider Directory

National Provider Directory

Locations

2986 Kate Bond Rd
Bartlett, TN 38133
Phone (901) 765-1000

5050 Poplar Ave
Memphis, TN 38157
Phone (901) 276-2662

5050 Poplar Ave
Ste 100
Memphis, TN 38157

5050 Poplar Ave
Ste 600
Memphis, TN 38157

5050 Poplar Ave
Ste 700
Memphis, TN 38157
Phone (901) 276-2662

5050 Poplar Ave
Ste 801
Memphis, TN 38157

Practitioners & affiliated clinicians

Practitioners 51

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 51

NPI Registry JSON

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

{
    "created_epoch": "1137369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573516800000",
    "number": "1073592275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5050 POPLAR AVE",
            "address_2": "SUITE 800",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381570101",
            "telephone_number": "901-276-2662",
            "fax_number": "901-274-1871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 POPLAR AVE",
            "address_2": "SUITE 800",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381570101",
            "telephone_number": "901-276-2662",
            "fax_number": "901-274-1871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-SOUTH PULMONARY SPECIALISTS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-16",
        "last_updated": "2019-11-12",
        "status": "A",
        "authorized_official_last_name": "AVERY",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "WEIS",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "901-333-8443",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "JD"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080S0012X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics, Sleep Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Nov 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.