NPIMap

Organization Active NPI

Medical Services of Meridian, Inc.

  • Emergency Medicine Physician
  • Memphis, TN
National Provider Identifier
1174095988
Registry record updated Dec 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
MEDICAL SERVICES OF MERIDIAN, INC.
Practice address
6075 Poplar Avenue
Suite 401
Memphis, TN 38119
Phone
(901) 795-3600
Fax
(901) 795-6060
NPI assigned
Dec 19, 2018
Last updated
Dec 19, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2018

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

Authorized official

Name
Glenn Adams
Title
President
Phone
(901) 795-3600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X NU Primary

Addresses

Primary practice location

6075 Poplar Avenue
Suite 401
Memphis, TN 38119

Mailing address

6075 Poplar Avenue
Suite 401
Memphis, TN 38119
Phone (901) 795-3600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190218000483 MS Part B Supplier - Clinic/Group Practice 7315285376 Receives reassigned benefits from 87 practitioners
Practice locations: Meridian, MS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 87

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.

View all 87

NPI Registry JSON

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

{
    "created_epoch": "1545177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545177600000",
    "number": "1174095988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6075 POPLAR AVENUE",
            "address_2": "SUITE 401",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38119",
            "telephone_number": "901-795-3600",
            "fax_number": "901-795-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6075 POPLAR AVENUE",
            "address_2": "SUITE 401",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38119",
            "telephone_number": "901-795-3600",
            "fax_number": "901-795-6060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL SERVICES OF MERIDIAN, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-19",
        "last_updated": "2018-12-19",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "GLENN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "901-795-3600"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Dec 19, 2018; 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.