Individual provider Active NPI

Stephen A Avera, MD

  • Student in an Organized Health Care Education/Training Program
  • Memphis, TN
National Provider Identifier
1174986293
Registry record updated May 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
0000059602 Issued in TN
Practice address
University of Tennessee 920 Madison Avenue Suite 447
Memphis, TN 38163-2933
Phone
(901) 448-5737
NPI assigned
Apr 5, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0000059602 TN
Internal Medicine Physician 207R00000X MD214746 OR
Student in an Organized Health Care Education/Training Program 390200000X 0000059602 TN Primary

Addresses

Primary practice location

University of Tennessee 920 Madison Avenue Suite 447
Memphis, TN 38163-2933

Mailing address

University of Tennessee 920 Madison Avenue Suite 534
Memphis, TN 38163-0001
Phone (901) 448-5737

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190913000534 TN Practitioner - Internal Medicine 4789913971 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0000059602TNMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon Internal Medicine Current Accepting new patients
Hospital Medicine Services of Tennessee PC Internal Medicine CurrentSince Aug 30, 2019 Accepting new patients
Providence Health & Services - Oregon Internal Medicine Current Accepting new patients

Locations

810 12th St
Hood River, OR 97031
Phone (541) 386-3911

4805 NE Glisan St
Portland, OR 97213
Phone (503) 215-1111

725 S Wahanna Rd
Seaside, OR 97138
Phone (503) 717-7000

742 Middle Creek Rd
Sevierville, TN 37862
Phone (865) 429-6100

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1459814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747180800000",
    "number": "1174986293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UNIVERSITY OF TENNESSEE 920 MADISON AVENUE SUITE 534",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381630001",
            "telephone_number": "901-448-5737",
            "fax_number": "901-448-7836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UNIVERSITY OF TENNESSEE 920 MADISON AVENUE SUITE 447",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381632933",
            "telephone_number": "901-448-5737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVERA",
        "first_name": "STEPHEN",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-05",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "0000059602",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD214746",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TN",
            "license": "0000059602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.