Patrickgrapevine

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

0000000475 Issued in TN

Legal business name

PATRICKGRAPEVINE

Practice address

1833 South Third Street
Memphis, TN 38109

Phone

(901) 550-1011

NPI assigned

Jun 26, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Coleman Thompson

Title

President Ceo

Phone

(901) 550-1011

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1214438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214438400000",
    "number": "1083876502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1833 S 3RD ST",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381097717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1833 SOUTH THIRD STREET",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38109",
            "telephone_number": "901-550-1011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRICKGRAPEVINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-26",
        "last_updated": "2008-06-26",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "COLEMAN",
        "authorized_official_title_or_position": "PRESIDENT CEO",
        "authorized_official_telephone_number": "901-550-1011",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "TN",
            "license": "0000000475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Patrick, MD
• Krisana Patrick
• Shelia Denise Patrick, PTA
• Trinade C Patrick, RBT
• Trisha Shea Patrick, APN
• Patriot Healthcare of Tennessee, LLC
• Patriot Healthcare of Tennessee, LLC
• Debendra N Pattanaik, MD
• Mark Randall Patters, DDS
• Patterson and Associates

• Community/Behavioral Health Agency in Memphis, TN
• Providers in Memphis, TN by specialty
• Community/Behavioral Health Agency in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2008; 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.