Active NPI
Audrey W Coo, M.D.
- Specialist
- Memphis, TN
National Provider Identifier
1114928124
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MD29587
- Practice address
- 2225 Union Ave
Suite 100
Memphis, TN 38104-4316 - Phone
- (901) 726-1161
- Fax
- (901) 726-0161
- NPI assigned
- Aug 2, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MD29587 | TN | Primary |
Addresses
Primary practice location
2225 Union Ave
Suite 100
Memphis, TN 38104-4316
Mailing address
2225 Union Ave
Suite 100
Memphis, TN 38104-4316
Phone (901) 726-1161
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3814497 | Medicaid | TN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060130000851 | TN | Practitioner - Internal Medicine | 6507870466 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- The Kidney Group of Memphis, PLLC
Practice addresses (Care Compare)
2225 Union Ave
Suite 100
Memphis, TN 38104-4391
Phone (901) 726-1161
3850 Austin Peay Hwy
Suite 10
Memphis, TN 38128-2517
Phone (901) 726-1161
7640 Wolf River Cir
Germantown, TN 38138-1713
Phone (901) 726-1161
Hospital & facility affiliations
- FMC Tipton County
- FMC Memphis Midtown
- Methodist Hospitals of Memphis
- Saint Francis Bartlett Medical Center
- St Francis Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD29587 | TN | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Kidney Group of Memphis, PLLC | Specialist | Current | Accepting new patients |
Locations
2225 Union Ave
Ste 100
Memphis, TN 38104
Phone (901) 726-1161
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/AAEFBD/Endpoint/AAEFBD
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Specialist
- Memphis, TN
- NPI 1467544643
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Covington, TN
- NPI 1114949005
Dialysis facility
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Memphis, TN
- NPI 1235241076
Dialysis facility
-
- General Acute Care Hospital
- Memphis, TN
- NPI 1558365890
Hospital
-
- General Acute Care Hospital
- Bartlett, TN
- NPI 1811929151
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1114928124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2225 UNION AVE",
"address_2": "SUITE 100",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381044316",
"telephone_number": "901-726-1161",
"fax_number": "901-726-0161"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2225 UNION AVE",
"address_2": "SUITE 100",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381044316",
"telephone_number": "901-726-1161",
"fax_number": "901-726-0161"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COO",
"first_name": "AUDREY",
"middle_name": "W",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-08-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "TN",
"license": "MD29587",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3814497",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.