Icp Tennessee Aco Billing LLC

Primary specialty

Clinical Nurse SpecialistTaxonomy code 364S00000X

Legal business name

ICP TENNESSEE ACO BILLING LLC

Practice address

5100 Poplar Ave Ste 2700
Memphis, TN 38137-2700

Phone

(855) 498-6767

Fax

(479) 968-1673

NPI assigned

May 12, 2021

Organization subpart

No

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

Authorized official

Name

Rodney Thomason

Title

Authorized Official

Phone

(501) 406-6180

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1620777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620777600000",
    "number": "1174107338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9178",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728119178",
            "telephone_number": "855-498-6767",
            "fax_number": "479-968-1673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 POPLAR AVE STE 2700",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381372700",
            "telephone_number": "855-498-6767",
            "fax_number": "479-968-1673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICP TENNESSEE ACO BILLING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-12",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A",
        "authorized_official_last_name": "THOMASON",
        "authorized_official_first_name": "RODNEY",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "501-406-6180"
    },
    "taxonomies": [
        {
            "code": "364S00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Nurse Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mariam Kerolos Ibraheem, MD
• Elsayed Elsayed Hassan Ibrahim
• Kadija Ibrahim
• Kalid Ibrahim
• Rasmia Ibrahim
• Mari Jordon Iezzi, APN
• Walter C Ifeadike, MD
• Ijeoma Chinego Ifedili, ACNP-BC, CCRN
• Ikechukwu Anthony Ifedili, MD
• Masanori Igarashi, MD

• Clinical Nurse Specialist in Memphis, TN
• Providers in Memphis, TN by specialty
• Clinical Nurse Specialist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2021; 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.