Active NPI
Midtown Injury & Physical Therapy Center P.C.
- General Practice Physician
- Memphis, TN
National Provider Identifier
1154461218
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3335622 | Medicaid | TN |
Other names 1
- Midtown Injury & Physical Therapy Center P.C.
National Provider Directory
National Provider DirectoryLocations
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.
-
- General Practice Physician
- Millington, TN
- NPI 1700094059
-
- Internal Medicine Physician
- Lutherville, MD
- NPI 1457304396
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.