NPIMap

Organization Active NPI

West Clinic,PC

  • Cardiovascular Disease Physician
  • Union City, TN
National Provider Identifier
1194953364
Registry record updated Oct 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
WEST CLINIC,PC
Practice address
1201 Bishop St
Union City, TN 38261-5403
Phone
(901) 818-0300
Fax
(901) 818-0458
NPI assigned
Jun 26, 2009
Organization subpart
Yes
Parent organization
WEST CLINIC, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 20, 2011

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

Authorized official

Name
Mr. Ronald O Davis
Title
Cfo
Phone
(901) 683-0055

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

1201 Bishop St
Union City, TN 38261-5403

Mailing address

100 N Humphreys Blvd
Memphis, TN 38120-2146
Phone (901) 309-4027

Other identifiers 1

IdentifierTypeStateIssuer
3704068MedicaidTN

Other names 1

  • Memphis Heart Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
The West Clinic PC38 organizations share this tax ID, including this one
Part of
The West Clinic PC

Other organizations with this tax ID 37

Organizations that report the same tax identification number in the National Provider Directory.

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1245974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319068800000",
    "number": "1194953364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N HUMPHREYS BLVD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202146",
            "telephone_number": "901-309-4027",
            "fax_number": "901-312-2664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 BISHOP ST",
            "city": "UNION CITY",
            "state": "TN",
            "postal_code": "382615403",
            "telephone_number": "901-818-0300",
            "fax_number": "901-818-0458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST CLINIC,PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WEST CLINIC, PC",
        "enumeration_date": "2009-06-26",
        "last_updated": "2011-10-20",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "901-683-0055",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3704068",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memphis Heart Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Union City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2011; 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.