NPIMap

Organization Active NPI

Ut Lebonheur Pediatric Specialists, Inc.

  • Pediatrics Physician
  • Memphis, TN
National Provider Identifier
1093024101
Registry record updated Sep 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
UT LEBONHEUR PEDIATRIC SPECIALISTS, INC.
Practice address
848 Adams Ave.
Memphis, TN 38103
Phone
(901) 287-7337
NPI assigned
Oct 7, 2010
Last updated
Sep 1, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2026

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

Authorized official

Name
Nyoka Bowman
Title
Supervisor
Phone
(901) 287-5594

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X
Pediatric Dermatology Physician 207NP0225X
Pediatric Otolaryngology Physician 207YP0228X
Pediatrics Physician 208000000X Primary
Pediatric Allergy/Immunology Physician 2080P0201X
Pediatric Cardiology Physician 2080P0202X
Pediatric Critical Care Medicine Physician 2080P0203X
Pediatric Endocrinology Physician 2080P0205X
Pediatric Gastroenterology Physician 2080P0206X
Pediatric Infectious Diseases Physician 2080P0208X
Pediatric Nephrology Physician 2080P0210X
Pediatric Pulmonology Physician 2080P0214X
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X
Pediatric Radiology Physician 2085P0229X
Pediatric Ophthalmology and Strabismus Specialist Physician 207WX0110X

Addresses

Primary practice location

848 Adams Ave.
Memphis, TN 38103

Mailing address

850 Poplar Ave.
BLDG. 2
Memphis, TN 38105
Phone (901) 287-5513

Other practice location 1

8001 Centerview Parkway
Cordova, TN 38018
Phone (901) 287-7337

Other practice location 2

848 Adams Ave.
Ste. L400
Memphis, TN 38103
Phone (901) 287-7337

Other practice location 3

6401 Poplar Ave
Ste. 324
Memphis, TN 38119
Phone (901) 287-7337

Other practice location 4

848 Adams Ave.
Ste. L201
Memphis, TN 38103
Phone (901) 287-7337

Other practice location 5

51 N Dunlap St Ste 400
Memphis, TN 38105-4625
Phone (901) 287-7337

Other practice location 6

51 N. Dunlap St.
2nd Floor
Memphis, TN 38105
Phone (901) 287-7337

Other practice location 7

4055 N Park Loop
Memphis, TN 38152
Phone (901) 678-2009

Other practice location 8

786 Estate Pl
Memphis, TN 38120-0600
Phone (901) 287-7337

Other practice location 9

620 Skyline Dr Fl 3
Jackson, TN 38301-3923
Phone (866) 870-5570

Other practice location 10

1535 Vann Dr
Jackson, TN 38305
Phone (731) 984-9944

Other practice location 11

1920 Kirby Parkway
Ste. 100
Germantown, TN 38138
Phone (901) 287-7337

Other practice location 12

51 N Dunlap St Ste G10
Memphis, TN 38105-4625
Phone (901) 287-7337

Other practice location 13

100 N Humphreys Blvd
Memphis, TN 38120-2146
Phone (901) 287-7337

Other practice location 14

942 Commonwealth Blvd
Tupelo, MS 38804
Phone (662) 620-0101

Other practice location 15

920 Estate Drive
Memphis, TN 38119
Phone (901) 287-7337

Other practice location 16

930 Madison Ave Ste 400
Memphis, TN 38103-7400
Phone (901) 287-7337

Other practice location 17

848 Adams Ave Ste L400
Memphis, TN 38103-2816
Phone (901) 287-7337

Other practice location 18

610 Brunson Dr
Tupelo, MS 38804
Phone (901) 287-7337

Other practice location 19

800 S Church St Ste 104
Jonesboro, AR 72401-4154
Phone (870) 336-1778

Other practice location 20

51 N. Dunlap St.
Ste. 350
Memphis, TN 38105
Phone (901) 287-7337

Other practice location 21

51 N Dunlap St Ste 100
Memphis, TN 38105-4625
Phone (901) 287-7337

Other identifiers 1

IdentifierTypeStateIssuer
1520268MedicaidTN

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20101130000117 TN Part B Supplier - Clinic/Group Practice 7719173939 Receives reassigned benefits from 592 practitioners
Practice locations: Memphis, TN; Jackson, TN; Germantown, TN; Cordova, TN
O20150409001576 MS Part B Supplier - Clinic/Group Practice 7719173939 Receives reassigned benefits from 12 practitioners
Practice locations: Tupelo, 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
44D0862078Ut Lebonheur Pediatric Specialists Inc51 N Dunlap Street, Memphis, TN 38105Provider-performed microscopyAug 31, 2026

National Provider Directory

National Provider Directory

Locations

7945 Wolf River Blvd
Ste 250
Germantown, TN 38138
Phone (901) 866-8817

620 Skyline Dr
Fl 3
Jackson, TN 38301
Phone (731) 541-0350

77 Stonebridge Blvd
Ste 13
Jackson, TN 38305
Phone (901) 287-5545

1407 Union Ave
Ste 200
Memphis, TN 38104
Phone (901) 866-8360

1920 Kirby Pkwy
Ste 100
Memphis, TN 38138
Phone (901) 751-9909

4055 N Park Loop
Memphis, TN 38152
Phone (901) 678-2003

51 N Dunlap St
Ste 100
Memphis, TN 38105
Phone (323) 783-1737

777 Washington Ave
#G10
Memphis, TN 38105
Phone (901) 287-4400

777 Washington Ave
Ste 350
Memphis, TN 38105
Phone (901) 866-8815

777 Washington Ave
Ste 400
Memphis, TN 38105
Phone (901) 866-8827

848 Adams Ave
Ste L201
Memphis, TN 38103
Phone (901) 287-6869

848 Adams Ave
Ste L400
Memphis, TN 38103
Phone (901) 287-4699

850 Poplar Ave
Bldg 2
Memphis, TN 38105
Phone (901) 287-5594

Practitioners & affiliated clinicians

Practitioners 663

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 663

NPI Registry JSON

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

{
    "created_epoch": "1286409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788220800000",
    "number": "1093024101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 POPLAR AVE.",
            "address_2": "BLDG. 2",
            "city": "MEMPHIS",
            "state": "TN",
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            "telephone_number": "901-287-5513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
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            "telephone_number": "901-287-7337"
        }
    ],
    "practiceLocations": [
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            "address_purpose": "LOCATION",
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            "postal_code": "38018",
            "country_code": "US",
            "telephone_number": "901-287-7337",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "848 Adams Ave.",
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            "country_code": "US",
            "telephone_number": "901-287-7337",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6401 Poplar Ave",
            "address_2": "Ste. 324",
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            "country_code": "US",
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            "country_name": "United States",
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        },
        {
            "address_1": "848 Adams Ave.",
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            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "51 N Dunlap St Ste 400",
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            "postal_code": "381054625",
            "country_code": "US",
            "telephone_number": "901-287-7337",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "51 N. Dunlap St.",
            "address_2": "2nd Floor",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "38105",
            "country_code": "US",
            "telephone_number": "901-287-7337",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4055 N Park Loop",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "38152",
            "country_code": "US",
            "telephone_number": "901-678-2009",
            "fax_number": "901-678-5497",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "786 Estate Pl",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381200600",
            "country_code": "US",
            "telephone_number": "901-287-7337",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "620 Skyline Dr Fl 3",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "TN",
            "postal_code": "383013923",
            "country_code": "US",
            "telephone_number": "866-870-5570",
            "fax_number": "731-541-8187",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1535 Vann Dr",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "TN",
            "postal_code": "38305",
            "country_code": "US",
            "telephone_number": "731-984-9944",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1920 Kirby Parkway",
            "address_2": "Ste. 100",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "TN",
            "postal_code": "38138",
            "country_code": "US",
            "telephone_number": "901-287-7337",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "51 N Dunlap St Ste G10",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381054625",
            "country_code": "US",
            "telephone_number": "901-287-7337",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 N Humphreys Blvd",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381202146",
            "country_code": "US",
            "telephone_number": "901-287-7337",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "942 Commonwealth Blvd",
            "address_purpose": "LOCATION",
            "city": "Tupelo",
            "state": "MS",
            "postal_code": "38804",
            "country_code": "US",
            "telephone_number": "662-620-0101",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "920 Estate Drive",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "38119",
            "country_code": "US",
            "telephone_number": "901-287-7337",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "930 Madison Ave Ste 400",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381037400",
            "country_code": "US",
            "telephone_number": "901-287-7337",
            "fax_number": "901-448-1813",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "848 Adams Ave Ste L400",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381032816",
            "country_code": "US",
            "telephone_number": "901-287-7337",
            "fax_number": "901-287-4540",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "610 Brunson Dr",
            "address_purpose": "LOCATION",
            "city": "Tupelo",
            "state": "MS",
            "postal_code": "38804",
            "country_code": "US",
            "telephone_number": "901-287-7337",
            "fax_number": "901-448-1813",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 S Church St Ste 104",
            "address_purpose": "LOCATION",
            "city": "Jonesboro",
            "state": "AR",
            "postal_code": "724014154",
            "country_code": "US",
            "telephone_number": "870-336-1778",
            "fax_number": "870-366-1780",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "51 N. Dunlap St.",
            "address_2": "Ste. 350",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "38105",
            "country_code": "US",
            "telephone_number": "901-287-7337",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "51 N Dunlap St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381054625",
            "country_code": "US",
            "telephone_number": "901-287-7337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "UT LEBONHEUR PEDIATRIC SPECIALISTS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-07",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A",
        "authorized_official_last_name": "BOWMAN",
        "authorized_official_first_name": "NYOKA",
        "authorized_official_title_or_position": "SUPERVISOR",
        "authorized_official_telephone_number": "901-287-5594"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2080P0201X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Allergy/Immunology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207WX0110X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1520268",
            "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 1, 2026; 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.