Mid South Regional Thoracic Center, LLC

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

MD5950415 Issued in TN

Legal business name

MID SOUTH REGIONAL THORACIC CENTER, LLC

Practice address

6029 Walnut Grove Rd
Suite 100
Memphis, TN 38120-2112

Phone

(901) 259-4130

Fax

(901) 259-4131

NPI assigned

Mar 3, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Mathew Ninan

Title

Owner

Phone

(901) 259-4130

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1267574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267574400000",
    "number": "1164745238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6029 WALNUT GROVE RD",
            "address_2": "SUITE 100",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202112",
            "telephone_number": "901-259-4130",
            "fax_number": "901-259-4131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6029 WALNUT GROVE RD",
            "address_2": "SUITE 100",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202112",
            "telephone_number": "901-259-4130",
            "fax_number": "901-259-4131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID SOUTH REGIONAL THORACIC CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-03",
        "last_updated": "2010-03-03",
        "status": "A",
        "authorized_official_last_name": "NINAN",
        "authorized_official_first_name": "MATHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "901-259-4130",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "TN",
            "license": "MD5950415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kewida Michaud, LPN
• Michelle James Family Care, PLLC
• Mid South Ambulatory Services, LLC
• Mid South Medical Associates
• Mid South Psychiatry, PLLC
• Mid South Residential Care Center
• Mid South Senior Care, LLC
• Mid South Supportive Living, LLC
• Mid South Vascular Clinic
• Mid-South ABA Therapy

• All providers in Memphis, TN
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2010; 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.