Organization Active NPI

Medical Center Endoscopy Group

  • Ambulatory Surgical Clinic/Center
  • Memphis, TN
National Provider Identifier
1083646491
Registry record updated Sep 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
0000000046 Issued in TN
Legal business name
MEDICAL CENTER ENDOSCOPY GROUP
Practice address
80 Humphreys Ctr
#200
Memphis, TN 38120-2353
Phone
(901) 578-2538
Fax
(901) 578-2572
NPI assigned
Jul 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2007

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

Authorized official

Name
Mr. Christopher A Holden
Title
Chief Manager of the LLC
Phone
(615) 665-1283

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 0000000046 TN Primary

Addresses

Primary practice location

80 Humphreys Ctr
#200
Memphis, TN 38120-2353

Mailing address

80 Humphreys Ctr
#200
Memphis, TN 38120-2353
Phone (901) 578-2538

Other identifiers 2

IdentifierTypeStateIssuer
3006899OtherTNBLUE CROSS OF TENNESSEE
3287680MedicaidTN

National Provider Directory

National Provider Directory

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": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190937600000",
    "number": "1083646491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 HUMPHREYS CTR",
            "address_2": "#200",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202353",
            "telephone_number": "901-578-2538",
            "fax_number": "901-578-2572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 HUMPHREYS CTR",
            "address_2": "#200",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202353",
            "telephone_number": "901-578-2538",
            "fax_number": "901-578-2572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL CENTER ENDOSCOPY GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2007-09-28",
        "status": "A",
        "authorized_official_last_name": "HOLDEN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIEF MANAGER OF THE LLC",
        "authorized_official_telephone_number": "615-665-1283",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "TN",
            "license": "0000000046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF TENNESSEE",
            "identifier": "3006899",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3287680",
            "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 Sep 28, 2007; 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.