Tri-State Neurology PLLC

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

MD0000030878 Issued in TN

Legal business name

TRI-STATE NEUROLOGY PLLC

Practice address

5100 Sanderlin Ave Ste 2100
Memphis, TN 38117-4387

Phone

(901) 820-0141

Fax

(901) 820-0144

NPI assigned

Dec 20, 2006

Last updated

Nov 30, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

James J WangNPI 1619945532

Title

President / Owner

Phone

(901) 820-0141

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in TN2 enrollments

Enrollment records 2

Locations

Practitioners 6

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.

• James J Wang, MD

  • Neurology Physician
  • Memphis, TN
  • NPI 1619945532
  Medicare reassignment Care Compare group Authorized official
• Amber Elizabeth Adams, NP

  • Adult Health Nurse Practitioner
  • Memphis, TN
  • NPI 1053791616
  Medicare reassignment Care Compare group NPD
• Rada Petrinjac-Nenadic, M.D.

  • Neurology Physician
  • Memphis, TN
  • NPI 1891911954
  Medicare reassignment Care Compare group NPD
• Pawan Virendra Rawal, M.B.B.S.

  • Neurology Physician
  • Memphis, TN
  • NPI 1255659009
  Medicare reassignment Care Compare group
• Ahmad B Al-Hamda, MD

  • Neurology with Special Qualifications in Child Neurology Physician
  • Muscle Shoals, AL
  • NPI 1851357586

  TN

  Medicare reassignment
• Laura L Finnern, DPT

  • Physical Therapist
  • Collierville, TN
  • NPI 1518907898
  NPD (past)

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512000000000",
    "number": "1184788762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 SANDERLIN AVE STE 2100",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381174387",
            "telephone_number": "901-820-0141",
            "fax_number": "901-820-0144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 SANDERLIN AVE STE 2100",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381174387",
            "telephone_number": "901-820-0141",
            "fax_number": "901-820-0144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-STATE NEUROLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-20",
        "last_updated": "2017-11-30",
        "status": "A",
        "authorized_official_last_name": "WANG",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT / OWNER",
        "authorized_official_telephone_number": "901-820-0141"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TN",
            "license": "MD0000030878",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "138488001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206187502",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00126261",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3838091",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tri State Community Health Center
• Tri State Community Health Center (Tri State Community Health Center Pharmacy)
• Tri-Med Pharmacy LLC (Orion Rx - Memphis)
• Tri-State Gastroenterology, P.C.
• Tri-State Medical Management
• Tri-State Orthopaedics, LLC
• Jada Anne Tribble, PA
• Trichocare Clinic
• Catalina Trieu, DO
• Jake Trigg

• Neurology Physician in Memphis, TN
• Providers in Memphis, TN by specialty
• Neurology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2017; 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.