NPIMap

Organization Active NPI

Conrad Pearson Clinic

  • Medical Specialty Clinic/Center
  • Germantown, TN
National Provider Identifier
1174864946
Registry record updated Mar 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
CONRAD PEARSON CLINIC
Practice address
1325 Wolf Park Dr Ste 102
Germantown, TN 38138-1759
Phone
(901) 252-4311
Fax
(901) 763-4305
NPI assigned
Mar 4, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2013

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

Authorized official

Name
Linda Wilson
Title
Credentialing Specialist
Phone
(901) 252-3411

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X Primary

Addresses

Primary practice location

1325 Wolf Park Dr Ste 102
Germantown, TN 38138-1759

Mailing address

1325 Wolf Park Dr Ste 103
Germantown, TN 38138-1759
Phone (901) 252-3411

National Provider Directory

National Provider Directory

Locations

1325 Wolf Park Dr
Ste 103
Memphis, TN 38138

Practitioners & affiliated clinicians

Practitioners 29

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

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1362355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362355200000",
    "number": "1174864946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 WOLF PARK DR STE 103",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381381759",
            "telephone_number": "901-252-3411",
            "fax_number": "901-763-4305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 WOLF PARK DR STE 102",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381381759",
            "telephone_number": "901-252-4311",
            "fax_number": "901-763-4305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONRAD PEARSON CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-04",
        "last_updated": "2013-03-04",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "901-252-3411"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.