Individual provider Active NPI

Tracye Denise Kyles, M.D.

  • Internal Medicine Physician
  • Memphis, TN
National Provider Identifier
1144395682
Registry record updated May 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
44506 Issued in TN
Practice address
5220 Park Ave
Suite 100
Memphis, TN 38119
Phone
(901) 685-8245
Fax
(901) 685-8248
NPI assigned
Nov 21, 2006
Last updated
May 26, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 026279 LA
Internal Medicine Physician 207R00000X 44506 TN Primary
Pediatrics Physician 208000000X 026279 LA

Addresses

Primary practice location

5220 Park Ave
Suite 100
Memphis, TN 38119

Mailing address

P.O. Box 405827
Atlanta, GA 30384-5827
Phone (870) 934-5821

Other identifiers 1

IdentifierTypeStateIssuer
1055531MedicaidLA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091104000189 TN Practitioner - Internal MedicinePractitioner - Pediatric Medicine 4082710470 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
University of Tennessee, HSC, College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5366 Mendenhall Mall
Memphis, TN 38115-4505
Phone (901) 271-6100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
026279LAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Christ Community Health Services, Inc CurrentSince Dec 14, 2020 Accepting new patients
Christ Community Health Services Inc CurrentSince Dec 14, 2020 Accepting new patients
Christ Community Health Services Inc Current Accepting new patients
Christ Community Health Services, Inc Past Accepting new patients
Christ Community Health Services Inc Past Accepting new patients

Locations

3362 S 3rd St
Memphis, TN 38109
Phone (901) 271-6300

5366 Mendenhall Mall
Memphis, TN 38115
Phone (901) 271-6100

969 Frayser Blvd
Memphis, TN 38127
Phone (901) 260-8400

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306368000000",
    "number": "1144395682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 405827",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303845827",
            "telephone_number": "870-934-5821",
            "fax_number": "870-934-5384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5220 PARK AVE",
            "address_2": "SUITE 100",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38119",
            "telephone_number": "901-685-8245",
            "fax_number": "901-685-8248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KYLES",
        "first_name": "TRACYE",
        "middle_name": "DENISE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2011-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "026279",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "44506",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "026279",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1055531",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.