NPIMap

Individual provider Active NPI

Jerry Ray Floyd, MD

  • Family Medicine Physician
  • Millington, TN
National Provider Identifier
1083779235
Registry record updated Feb 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD0000028821 Issued in TN
Practice address
8507 US Highway 51 N
Suite 107
Millington, TN 38053-1535
Phone
(901) 873-2555
Fax
(901) 873-2561
NPI assigned
Dec 27, 2006
Last updated
Feb 12, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD0000028821 TN Primary

Addresses

Primary practice location

8507 US Highway 51 N
Suite 107
Millington, TN 38053-1535

Mailing address

8507 Hwy 51 N
Suite 107
Millington, TN 38053-1535
Phone (901) 873-2555

Other identifiers 1

IdentifierTypeStateIssuer
3378384MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100331000127 TN Practitioner - Family Practice 9638120470 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Francis Physician Network, LLCGroup PAC ID 2365701943, 74 clinicians

Practice addresses (Care Compare)

8507 US Hwy 51 N
Suite 107
Millington, TN 38053-1535
Phone (901) 873-2555

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD0000028821TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eric Blakney Current Accepting new patients
Saint Francis Physician Network, LLC Family Medicine CurrentSince Feb 5, 2018 Accepting new patients
Mid South Wellness Center, Inc Family Medicine PastSince Jun 24, 2002 Accepting new patients

Locations

8025 US Highway 64
Ste 101
Bartlett, TN 38133
Phone (901) 382-2044

6005 Park Ave
Ste 323B
Memphis, TN 38119
Phone (901) 756-6991

6005 Park Ave
Ste 601
Memphis, TN 38119
Phone (901) 680-9205

8507 US Highway 51 N
Ste 107
Millington, TN 38053
Phone (901) 873-2555

Interoperability endpoints

  • Direct secure messaging: jerry.floyd.1@16700.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423699200000",
    "number": "1083779235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8507 HWY 51 N",
            "address_2": "SUITE 107",
            "city": "MILLINGTON",
            "state": "TN",
            "postal_code": "380531535",
            "telephone_number": "901-873-2555",
            "fax_number": "901-873-2561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8507 US HIGHWAY 51 N",
            "address_2": "SUITE 107",
            "city": "MILLINGTON",
            "state": "TN",
            "postal_code": "380531535",
            "telephone_number": "901-873-2555",
            "fax_number": "901-873-2561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLOYD",
        "first_name": "JERRY",
        "middle_name": "RAY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2015-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD0000028821",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3378384",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Millington, TN

Sources for this page

Verify at the official NPI Registry.