Organization Active NPI

Midtown Injury & Physical Therapy Center P.C.

  • General Practice Physician
  • Memphis, TN
National Provider Identifier
1154461218
Registry record updated Jan 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
MIDTOWN INJURY & PHYSICAL THERAPY CENTER P.C.
Practice address
1488 Madison Ave
Memphis, TN 38104-2447
Phone
(901) 726-4110
Fax
(901) 726-4106
NPI assigned
Feb 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2013

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

Authorized official

Name
Dr. Jerry Lee Lovelace, M.D.
Title
Owner
Phone
(901) 726-4108

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

1488 Madison Ave
Memphis, TN 38104-2447

Mailing address

1488 Madison Ave
Memphis, TN 38104-2447
Phone (901) 726-4110

Other identifiers 1

IdentifierTypeStateIssuer
3335622MedicaidTN

Other names 1

  • Midtown Injury & Physical Therapy Center P.C. Former legal business name

National Provider Directory

National Provider Directory

Locations

4771 Easley Ave
Millington, TN 38053
Phone (901) 873-2653

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359331200000",
    "number": "1154461218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1488 MADISON AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381042447",
            "telephone_number": "901-726-4110",
            "fax_number": "901-726-4106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1488 MADISON AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381042447",
            "telephone_number": "901-726-4110",
            "fax_number": "901-726-4106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDTOWN INJURY & PHYSICAL THERAPY CENTER P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2013-01-28",
        "status": "A",
        "authorized_official_last_name": "LOVELACE",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "901-726-4108",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3335622",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Midtown Injury & Physical Therapy Center P.C.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Jan 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.