NPIMap

Organization Active NPI

Baptist Memorial Hospital-Tipton

Doing business as Walnut Grove Plaza Pharmacy #2

  • Community/Retail Pharmacy
  • Memphis, TN
National Provider Identifier
1114464211
Registry record updated Feb 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
0000005929 Issued in TN
Legal business name
BAPTIST MEMORIAL HOSPITAL-TIPTON
Doing business as
Walnut Grove Plaza Pharmacy #2
Practice address
6029 Walnut Grove Rd Ste 110
Memphis, TN 38120-2110
Phone
(844) 605-5496
Fax
(901) 226-2496
NPI assigned
Jan 26, 2017
Last updated
Feb 14, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
BAPTIST MEMORIAL HEALTH CARE CORP.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 14, 2024

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

Authorized official

Name
Arthur Maples
Title
Director
Phone
(901) 227-4137

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X 0000005929 TN Primary
Specialty Pharmacy 3336S0011X NU

Addresses

Primary practice location

6029 Walnut Grove Rd Ste 110
Memphis, TN 38120-2110

Mailing address

350 N Humphreys Blvd
Memphis, TN 38120-2177
Phone (817) 572-0009

Other identifiers 1

IdentifierTypeStateIssuer
2167409OtherPK

Other names 1

  • Walnut Grove Plaza Pharmacy #2 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170626001536 TN Part B Supplier - Mass Immunization (Roster Biller Only) 1052546793 Practice locations: Memphis, TN

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Baptist Memorial Hospital-Tipton5 organizations share this tax ID, including this one
Part of
Baptist Memorial Health Care Corp

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

36 Capital Way
Ste A
Atoka, TN 38004
Phone (901) 837-6620

6027 Walnut Grove Rd
Ste 110
Memphis, TN 38120
Phone (844) 605-5496

6027 Walnut Grove Rd
Ste 206
Memphis, TN 38120
Phone (901) 226-5151

6029 Walnut Grove Rd
Ste 110
Memphis, TN 38120
Phone (844) 605-5496

6029 Walnut Grove Rd
Ste 210
Memphis, TN 38120
Phone (901) 226-4910

6029 Walnut Grove Rd
Ste C1
Memphis, TN 38120
Phone (901) 227-1180

1109 E Reelfoot Ave
Ste Gh
Union City, TN 38261
Phone (731) 884-1720

Practitioners & affiliated clinicians

Practitioners 57

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 57

NPI Registry JSON

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

{
    "created_epoch": "1485388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707868800000",
    "number": "1114464211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 N HUMPHREYS BLVD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202177",
            "telephone_number": "817-572-0009",
            "fax_number": "817-720-1039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6029 WALNUT GROVE RD STE 110",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202110",
            "telephone_number": "844-605-5496",
            "fax_number": "901-226-2496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAPTIST MEMORIAL HOSPITAL-TIPTON",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BAPTIST MEMORIAL HEALTH CARE CORP.",
        "enumeration_date": "2017-01-26",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A",
        "authorized_official_last_name": "MAPLES",
        "authorized_official_first_name": "ARTHUR",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "901-227-4137"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TN",
            "license": "0000005929",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2167409",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Walnut Grove Plaza Pharmacy #2",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Walnut Grove Plaza Pharmacy #2",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Feb 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.