Mid-South Cardiovascular Center, LLC

Organization Active NPI Cardiovascular Disease Physician · Memphis, TN

NPI 1124171590 · NPPES record last updated May 20, 2025

Key facts

NPI
1124171590
Entity type
Organization (NPI type 2)
Primary specialty
Cardiovascular Disease Physician 207RC0000X
License
35778 (TN)
Legal business name
MID-SOUTH CARDIOVASCULAR CENTER, LLC
Practice address
4066 Summer Ave
Memphis, TN 38122-5262
Phone
(901) 725-2222
Fax
(901) 725-1133
NPI assigned
Jan 19, 2007
Organization subpart
No

Authorized official

Name
Someswara Reddy Karri, MD
Title
President
Phone
(901) 725-2222

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in TN, AR

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20081218000712 TN Part B Supplier - Clinic/Group Practice 8729020292 Receives reassigned benefits from 1 practitioner
Practice locations: Memphis, TN
O20150611002968 AR Part B Supplier - Clinic/Group Practice 8729020292 Receives reassigned benefits from 1 practitioner
Practice locations: Blytheville, AR; Helena, AR

National Provider Directory

Locations

1211 Union Ave
Ste 495
Memphis, TN 38104
Phone (901) 507-5835

1211 Union Ave
Ste 150
Memphis, TN 38104
Phone (901) 725-2222

4066 Summer Ave
Memphis, TN 38122
Phone (901) 452-7391

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207RC0000X 35778 TN Yes

Addresses

Primary practice location

4066 Summer Ave
Memphis, TN 38122-5262

Mailing address

PO Box 382668
Germantown, TN 38183-2668
Phone (901) 725-2222

Other identifiers

IdentifierTypeStateIssuer
20573241MedicaidMO
99220MedicaidAR
3869275MedicaidTN
00125364MedicaidMS

Other providers in Memphis, TN

All providers in Memphis, TN · Cardiovascular Disease Physician in Tennessee

Sources for this page

Verify at the official NPI Registry.