Individual provider Active NPI

Daniel Ray Pike, MD

  • Family Medicine Physician
  • Memphis, TN
National Provider Identifier
1205096351
Registry record updated Mar 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
47434 Issued in TN
Practice address
2569 Douglass Ave
Memphis, TN 38114-2532
Phone
(901) 701-2550
Fax
(901) 260-8449
NPI assigned
Jun 12, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X LL30976 SC
Family Medicine Physician 207Q00000X 47434 TN Primary

Addresses

Primary practice location

2569 Douglass Ave
Memphis, TN 38114-2532

Mailing address

2595 Central Ave
Memphis, TN 38104-5905
Phone (901) 260-8500

Other identifiers 1

IdentifierTypeStateIssuer
1524486MedicaidTN

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
I20110907001570 TN Practitioner - Family Practice 3476606476 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Louisville School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2569 Douglas Ave
Memphis, TN 38114-2532
Phone (901) 271-6200

3362 S 3Rd St
Memphis, TN 38109-2944
Phone (901) 271-6300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LL30976SCMDFamily Medicine Physician
30976SCMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Christ Community Health Services Inc Current Accepting new patients
Christ Community Health Services, Inc CurrentSince Aug 1, 2011 Accepting new patients
Christ Community Health Services Inc CurrentSince Aug 1, 2011 Accepting new patients
Christ Community Health Services Inc Past Accepting new patients
Baptist Memorial Hospital Past Accepting new patients
Christ Community Health Services Inc Past Accepting new patients

Locations

2569 Douglass Ave
Memphis, TN 38114
Phone (901) 271-6200

1325 Jefferson Ave
Memphis, TN 38104
Phone (901) 701-2530

2861 Broad Ave
Memphis, TN 38112
Phone (901) 260-8500

5366 Mendenhall Mall
Memphis, TN 38115
Phone (901) 271-6100

2595 Central Ave
Memphis, TN 38104
Phone (901) 260-8500

3362 S 3rd St
Memphis, TN 38109
Phone (901) 271-6300

969 Frayser Blvd
Memphis, TN 38127
Phone (901) 260-8400

3481 Austin Peay Hwy
Memphis, TN 38128
Phone (901) 701-2570

Organizations & group practices 6

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": "1213228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427673600000",
    "number": "1205096351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2595 CENTRAL AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381045905",
            "telephone_number": "901-260-8500",
            "fax_number": "901-260-8598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2569 DOUGLASS AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381142532",
            "telephone_number": "901-701-2550",
            "fax_number": "901-260-8449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIKE",
        "first_name": "DANIEL",
        "middle_name": "RAY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-12",
        "last_updated": "2015-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "LL30976",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "47434",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1524486",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.