Tennessee PHS PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

TENNESSEE PHS PC

Practice address

9155 Crestwyn Hills Dr
Memphis, TN 38125-8501

Phone

(901) 261-4858

Fax

(901) 261-4867

NPI assigned

Jul 21, 2009

Organization subpart

Yes

Parent organization

PROVIDER HEALTH SERVICES LLCAs reported in NPPES

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

Authorized official

Name

Nicole Howard

Title

Cfo

Phone

(337) 991-9276

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1248134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404259200000",
    "number": "1184854473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1509 DULLES DRIVE",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "70506",
            "telephone_number": "337-991-9276",
            "fax_number": "337-991-9288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9155 CRESTWYN HILLS DR",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381258501",
            "telephone_number": "901-261-4858",
            "fax_number": "901-261-4867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TENNESSEE PHS PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROVIDER HEALTH SERVICES LLC",
        "enumeration_date": "2009-07-21",
        "last_updated": "2014-07-02",
        "status": "A",
        "authorized_official_last_name": "HOWARD",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "337-991-9276"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1519862",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Tennessee TR Centers, PLLC
• Tennessee Training Academy
• Danielle Tennial

• Family Medicine Physician in Memphis, TN
• Providers in Memphis, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2014; 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.