Wellness One Memphis PC
Organization Active NPI Sports Medicine (Family Medicine) Physician · Memphis, TN
NPI 1124497730 · NPPES record last updated Jul 25, 2025
Key facts
- NPI
- 1124497730
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Sports Medicine (Family Medicine) Physician 207QS0010X
- Legal business name
- WELLNESS ONE MEMPHIS PC
- Practice address
- 6100 Primacy Pkwy Ste 112
Memphis, TN 38119-0705 - Phone
- (901) 682-5335
- Fax
- (901) 682-5440
- NPI assigned
- Sep 24, 2015
- Organization subpart
- No
Authorized official
- Name
- Dr. Russell D Radican, DC
- Title
- President
- Phone
- (901) 682-5335
Practitioners 16
-
Timothy J Callaghan, M.D.
-
Amy White, CNM
-
Laura Brasher, FNP
-
Howard Bromley, MD
-
Arifa Kathawala, M.D.
-
John P Blakely, DO
-
David E Buechner, MD
-
Rickey R Carson, MD
-
Betsy Adair Cordell, APN, FNP
-
Demetria Leonard Davis, PA-C
-
Sheryl Blaiss Kirk, FNP
-
Robert Larry Smith, FNP-BC
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 44D2022894 | Wellness One Memphis, PC | Certificate of waiver | Apr 11, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180108002392 | TN | Part B Supplier - Clinic/Group Practice | 7911266408 |
Receives reassigned benefits from 3 practitioners Practice locations: Memphis, TN |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | |||
| Sports Medicine (Family Medicine) Physician |
207QS0010X | Yes | ||
| Family Nurse Practitioner |
363LF0000X |
Addresses
Primary practice location
6100 Primacy Pkwy Ste 112
Memphis, TN 38119-0705
Mailing address
6100 Primacy Pkwy Ste 112
Memphis, TN 38119-0705
Phone (901) 682-5335
Other providers in Memphis, TN
- Wellness Ambulatory Care Inc.
- Wellness Ambulatory Care Inc.
- Wellness Ambulatory Care Inc.
- Wellness Evaluation Services, Inc
- Wellness First Inc
- Christopher Louis Wells
- Daniel Wells
- Danielle Wells
- Drew Wells
- Kara Wells
All providers in Memphis, TN · Sports Medicine (Family Medicine) Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 25, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.