Organization Active NPI

Adult Medical Group, PLLC

  • Internal Medicine Physician
  • Memphis, TN
National Provider Identifier
1225067499
Registry record updated Jan 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD3791 Issued in TN
Legal business name
ADULT MEDICAL GROUP, PLLC
Practice address
6025 Walnut Grove Rd
417
Memphis, TN 38120-2131
Phone
(901) 685-9165
Fax
(901) 685-1481
NPI assigned
Jul 1, 2006
Last updated
Jan 2, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2008

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

Authorized official

Name
Arnold M Drake, MD
Title
Manager
Phone
(901) 685-9165

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD0000022218 TN
Internal Medicine Physician 207R00000X MD27722 TN
Internal Medicine Physician 207R00000X MD11043 TN
Internal Medicine Physician 207R00000X MD34107 TN
Internal Medicine Physician 207R00000X MD3791 TN Primary

Addresses

Primary practice location

6025 Walnut Grove Rd
417
Memphis, TN 38120-2131

Mailing address

6025 Walnut Grove Rd
417
Memphis, TN 38120-2131
Phone (901) 685-9165

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199232000000",
    "number": "1225067499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6025 WALNUT GROVE RD",
            "address_2": "417",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202131",
            "telephone_number": "901-685-9165",
            "fax_number": "901-685-1481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6025 WALNUT GROVE RD",
            "address_2": "417",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202131",
            "telephone_number": "901-685-9165",
            "fax_number": "901-685-1481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADULT MEDICAL GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-01",
        "last_updated": "2008-01-02",
        "status": "A",
        "authorized_official_last_name": "DRAKE",
        "authorized_official_first_name": "ARNOLD",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "901-685-9165",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD0000022218",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD27722",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD11043",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD34107",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD3791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2008; 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.