NPIMap

Organization Active NPI

Medical Group of Memphis LLC

  • Specialist
  • Germantown, TN
National Provider Identifier
1265589261
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
MEDICAL GROUP OF MEMPHIS LLC
Practice address
8040 Wolf River Blvd
Suite #200
Germantown, TN 38138
Phone
(901) 726-0200
Fax
(901) 726-0210
NPI assigned
Jan 4, 2007
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mr. Roger Struble
Title
Executive Director
Phone
(901) 726-0200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X TN Primary

Addresses

Primary practice location

8040 Wolf River Blvd
Suite #200
Germantown, TN 38138

Mailing address

8040 Wolf River Blvd
Suite #200
Germantown, TN 38138
Phone (901) 726-0200

Other names 1

  • The Medical Group LLC Former legal business name

National Provider Directory

National Provider Directory

Locations

1500 W Poplar Ave
Ste 308
Collierville, TN 38017
Phone (901) 861-8550

2100 Exeter Rd
Memphis, TN 38138
Phone (901) 757-1350

Practitioners & affiliated clinicians

Practitioners 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1265589261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8040 WOLF RIVER BLVD",
            "address_2": "SUITE #200",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "38138",
            "telephone_number": "901-726-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8040 WOLF RIVER BLVD",
            "address_2": "SUITE #200",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "38138",
            "telephone_number": "901-726-0200",
            "fax_number": "901-726-0210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL GROUP OF MEMPHIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-04",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "STRUBLE",
        "authorized_official_first_name": "ROGER",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "901-726-0200",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "TN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Medical Group LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Germantown, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.