Active NPI
Pediatric Radiology
- Pediatric Radiology Physician
- Memphis, TN
National Provider Identifier
1225159643
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Radiology Physician
- License
- MD6355
- Legal business name
- PEDIATRIC RADIOLOGY
- Practice address
- 806 Estate PL
Memphis, TN 38148-0001 - Phone
- (901) 737-3071
- NPI assigned
- Apr 3, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tonya Malady
- Title
- Billing
- Phone
- (901) 737-3071
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Radiology Physician | 2085P0229X | MD6355 | TN | Primary |
Addresses
Primary practice location
806 Estate PL
Memphis, TN 38148-0001
Mailing address
806 Estate PL
Memphis, TN 38148-0001
Phone (901) 737-3071
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3000746 | Medicaid | TN |
National Provider Directory
National Provider DirectoryLocations
806 Estate Pl
Memphis, TN 38120
Phone (901) 572-3031
6141 Walnut Grove Rd
Ste 200
Memphis, TN 38120
Phone (901) 747-4121
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pediatric Radiology Physician
- Memphis, TN
- NPI 1013974195
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175558400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1225159643",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "806 ESTATE PL",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381480001",
"telephone_number": "901-737-3071"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "806 ESTATE PL",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381480001",
"telephone_number": "901-737-3071"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PEDIATRIC RADIOLOGY",
"organizational_subpart": "NO",
"enumeration_date": "2007-04-03",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "MALADY",
"authorized_official_first_name": "TONYA",
"authorized_official_title_or_position": "BILLING",
"authorized_official_telephone_number": "901-737-3071"
},
"taxonomies": [
{
"code": "2085P0229X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Radiology, Pediatric Radiology",
"state": "TN",
"license": "MD6355",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3000746",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Memphis, TN
- Pediatric Dental Care of Memphis, PLLC
- Pediatric Dentistry of Memphis PLLC
- Pediatric Emergency Specialists, PC
- Pediatric Partners of Memphis, LLC
- Pediatric Psychiatric Professional LLC
- Pediatric Sedation Specialists, PC
- Pediatric Surgical Group Inc
- Pediatric Therapy Services, LLC
- Pediatric Vision Associates, PLLC
- Erin H Peeden
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.