Individual provider Active NPI

Tasha J Ford, MD

  • Emergency Medicine Physician
  • Memphis, TN
National Provider Identifier
1205836566
Registry record updated May 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
31431 Issued in TN
Practice address
877 Jefferson Ave
Memphis, TN 38103-2807
Phone
(901) 545-8699
Fax
(901) 545-8998
NPI assigned
Jul 28, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Emergency Medicine) Physician 207PP0204X 31431 TN
Emergency Medicine Physician 207P00000X 31431 TN Primary

Addresses

Primary practice location

877 Jefferson Ave
Memphis, TN 38103-2807

Mailing address

842 Jefferson Ave
Suite A645
Memphis, TN 38103-2808
Phone (901) 545-8699

Other identifiers 1

IdentifierTypeStateIssuer
3633676MedicaidTN

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
I20060615000253 TN Practitioner - Emergency MedicinePractitioner - Internal Medicine 9234141193 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Internal Medicine
Education
University of North Carolina at Chapel Hill School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Emergency Physicians LLCGroup PAC ID 2466364997, 776 clinicians

Practice addresses (Care Compare)

2986 Kate Bond Rd
Bartlett, TN 38133-4003
Phone (901) 820-7000

9352 Park W Blvd
Knoxville, TN 37923-4325
Phone (865) 373-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31431TNMDPediatric Emergency Medicine (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Oct 1, 2022 Accepting new patients
T M Carr MD PC Emergency Medicine Past Accepting new patients

Locations

2986 Kate Bond Rd
Bartlett, TN 38133
Phone (901) 765-1000

9352 Park West Blvd
Knoxville, TN 37923
Phone (865) 373-1000

265 Brookview Centre Way
Ste 203
Knoxville, TN 37919
Phone (865) 500-1254

5959 Park Ave
Memphis, TN 38119
Phone (901) 765-1000

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463097600000",
    "number": "1205836566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "842 JEFFERSON AVE",
            "address_2": "SUITE A645",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381032808",
            "telephone_number": "901-545-8699",
            "fax_number": "901-545-8998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "877 JEFFERSON AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381032807",
            "telephone_number": "901-545-8699",
            "fax_number": "901-545-8998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORD",
        "first_name": "TASHA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-28",
        "last_updated": "2016-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "TN",
            "license": "31431",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "31431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3633676",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.