Individual provider Active NPI

Nour Mohammad Yadak, M.D

  • Anatomic Pathology & Clinical Pathology Physician
  • Memphis, TN
National Provider Identifier
1215292594
Registry record updated Aug 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
57458 Issued in TN
Practice address
1265 Union Ave
Memphis, TN 38104-3415
Phone
(901) 516-7182
Fax
(901) 276-5474
NPI assigned
Jul 11, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 57458 TN Primary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 26462 MS

Addresses

Primary practice location

1265 Union Ave
Memphis, TN 38104-3415

Mailing address

PO Box 603283
Charlotte, NC 28260-3283
Phone (866) 789-4893

Other practice location 1

51 Germantown Ct Ste 309
Cordova, TN 38018-4290
Phone (901) 333-0510

Other practice location 2

7900 Airways Blvd Ste 100
Southaven, MS 38671-4113
Phone (662) 349-6950

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20181008001872 TN Practitioner - Pathology 4880832724 Reassigns benefits to 2 organizations
I20190304000035 MS Practitioner - Pathology 4880832724

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

877 Jefferson Ave
Memphis, TN 38103-2807
Phone (901) 545-7100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57458TNMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Medical Group Inc Anatomic Pathology & Clinical Pathology CurrentSince Nov 15, 2021 Accepting new patients
Shelby County Health Care Corporation Anatomic Pathology & Clinical Pathology CurrentSince Jan 1, 2022 Accepting new patients
Shelby County Health Care Corporation CurrentSince Jan 1, 2022 Accepting new patients
Ut Medical Group, Inc. CurrentSince Nov 15, 2021 Accepting new patients

Locations

4250 Bethel Rd
Olive Branch, MS 38654
Phone (662) 932-9000

1265 Union Ave
#6
Memphis, TN 38104
Phone (901) 726-2305

1265 Union Ave
Memphis, TN 38104
Phone (901) 516-2362

930 Madison Ave
Ste 200
Memphis, TN 38103
Phone (901) 448-6650

877 Jefferson Ave
Memphis, TN 38103
Phone (901) 448-5893

Interoperability endpoints

  • Direct secure messaging: nour.yadak.p3@direct.uthsc.nextgenshare.com

Organizations & group practices 4

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": "1341964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787184000000",
    "number": "1215292594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 603283",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282603283",
            "telephone_number": "866-789-4893",
            "fax_number": "678-459-0526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 UNION AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381043415",
            "telephone_number": "901-516-7182",
            "fax_number": "901-276-5474"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "51 Germantown Ct Ste 309",
            "address_purpose": "LOCATION",
            "city": "Cordova",
            "state": "TN",
            "postal_code": "380184290",
            "country_code": "US",
            "telephone_number": "901-333-0510",
            "fax_number": "901-747-2380",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7900 Airways Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Southaven",
            "state": "MS",
            "postal_code": "386714113",
            "country_code": "US",
            "telephone_number": "662-349-6950",
            "fax_number": "662-349-6634",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YADAK",
        "first_name": "NOUR",
        "middle_name": "MOHAMMAD",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-11",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TN",
            "license": "57458",
            "primary": true
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MS",
            "license": "26462",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.