Memphis Spine and Sport, PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2912 Issued in TN

Legal business name

MEMPHIS SPINE AND SPORT, PLLC

Practice address

1740 N Germantown Pkwy
Suite 6
Cordova, TN 38016-3307

Phone

(901) 752-4300

Fax

(901) 244-7072

NPI assigned

Sep 15, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Charles Mazas Hogan, DC

Title

Owner

Phone

(901) 752-4300

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1473897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522368000000",
    "number": "1104374412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1740 N GERMANTOWN PKWY",
            "address_2": "SUITE 6",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380163307",
            "telephone_number": "901-752-4300",
            "fax_number": "901-244-7072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 N GERMANTOWN PKWY",
            "address_2": "SUITE 6",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380163307",
            "telephone_number": "901-752-4300",
            "fax_number": "901-244-7072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMPHIS SPINE AND SPORT, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-15",
        "last_updated": "2018-03-30",
        "status": "A",
        "authorized_official_last_name": "HOGAN",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "MAZAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "901-752-4300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "2912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Memphis Psychiatry, PLLC
• Memphis Regenerative Healthcare LLC
• Memphis Sleep Lab, Inc
• Memphis Speech-Language Pathology PLLC
• Memphis Spine and Sport
• Memphis Urgent Care #2 LLC
• Memphis Urgent Care #2 LLC
• Angela J Mennefield, MA, CCC-SLP
• Yamini Menon, MD
• Methodist Healthcare Community Care Associates

• Chiropractor in Cordova, TN
• Providers in Cordova, TN by specialty
• Chiropractor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2018; 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.