Poplar Avenue Clinic PLLC

Primary specialty

Gynecologic Oncology PhysicianTaxonomy code 207VX0201X

Legal business name

POPLAR AVENUE CLINIC PLLC

Doing business as

Poplar Avenue Clinic PLLC

Practice address

6584 Poplar Ave Ste 400
Memphis, TN 38138-3687

Phone

(901) 300-6713

Fax

(901) 552-5891

NPI assigned

Mar 20, 2019

Last updated

Sep 6, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Huda Alaeddin

Title

Office Manager

Phone

(901) 870-8840

Specialties & licenses 13

Addresses

Other identifiers 2

Other names 1

• Poplar Avenue Clinic PLLC Doing business as

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Practitioners 12

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.

• Adio Ishmael Abdu, M.D.

  • Obstetrics & Gynecology Physician
  • Germantown, TN
  • NPI 1861615627
  Medicare reassignment NPD
• Dwight Anthony Dishmon, MD

  • Interventional Cardiology Physician
  • Memphis, TN
  • NPI 1316904048
  Medicare reassignment NPD
• Kendall Sacharczyk, WHNP-BC

  • Women's Health Nurse Practitioner
  • Germantown, TN
  • NPI 1427603323
  Medicare reassignment NPD
• Jayanta Kumar Dirghangi, M.D.

  • Obstetrics & Gynecology Physician
  • Ashburn, VA
  • NPI 1548333636

  TN

  Medicare reassignment NPD
• NFN Sumedha, MD

  • Internal Medicine Physician
  • Apex, NC
  • NPI 1124220025

  TN

  Medicare reassignment NPD
• Jacqueline Yaa Konadu Asamoah

  • Physician Assistant
  • Cordova, TN
  • NPI 1255177853
  Medicare reassignment
• Ashara Beverly

  • Physician Assistant
  • Memphis, TN
  • NPI 1699467654
  Medicare reassignment
• Olivia Francis Coleman-Scruggs, PA-C

  • Physician Assistant
  • Memphis, TN
  • NPI 1639804537
  Medicare reassignment
• Melinda Homa

  • Surgical Physician Assistant
  • Memphis, TN
  • NPI 1104569649
  Medicare reassignment
• Paige Madisyn Theuer, PA-C

  • Physician Assistant
  • Raleigh, NC
  • NPI 1982299871

  TN

  Medicare reassignment
• Loretta Lambert Shamley, APN-BC, FNP

  • Family Nurse Practitioner
  • Collierville, TN
  • NPI 1770728784
  NPD
• Albert Earle Weeks, M.D.

  • Medical Oncology Physician
  • Germantown, TN
  • NPI 1336147263
  NPD

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

{
    "created_epoch": "1553040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662422400000",
    "number": "1124588793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 172344",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381872344",
            "telephone_number": "901-870-8840",
            "fax_number": "901-552-5891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6584 POPLAR AVE STE 400",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381383687",
            "telephone_number": "901-300-6713",
            "fax_number": "901-552-5891"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1726 Poplar Ave",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381046426",
            "country_code": "US",
            "telephone_number": "901-300-6713",
            "fax_number": "901-881-0337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "POPLAR AVENUE CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-20",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A",
        "authorized_official_last_name": "ALAEDDIN",
        "authorized_official_first_name": "HUDA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "901-870-8840"
    },
    "taxonomies": [
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0050X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Family Planning, Non-Surgical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6528091",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "893541",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Poplar Avenue Clinic PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Madison Poovey, DC
• Barbara Aquadro Pope, APRN, BC
• Lucille Fletcher Pope, RD
• Ronald V Pope, CMSW
• Todd Pope, B.S.
• Poplar Healthcare, PLLC
• Poplar Medical, LLC
• Poplar Podiatry PC
• Poplar Primary Care PC
• Ariel Ramiez Porcalla, M.D., M.P.H.

• Gynecologic Oncology Physician in Memphis, TN
• Providers in Memphis, TN by specialty
• Gynecologic Oncology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2022; 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.