NPIMap

Organization Active NPI

Shelby Residential & Vocational Services, Inc.

  • Intellectual Disabilities Intermediate Care Facility
  • Memphis, TN
National Provider Identifier
1265689293
Registry record updated May 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
L323-067-6611 Issued in TN
Legal business name
SHELBY RESIDENTIAL & VOCATIONAL SERVICES, INC.
Practice address
2115 Saint James Dr
Memphis, TN 38116-7670
Phone
(901) 332-9874
Fax
(901) 312-9906
NPI assigned
Aug 21, 2008
Organization subpart
Yes
Parent organization
SHELBY RESIDENTIAL & VOCATIONAL SERVICES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 2, 2024

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

Authorized official

Name
Shannon Durbin
Title
Executive Director
Phone
(901) 821-1067

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X L323-067-6611 TN Primary

Addresses

Primary practice location

2115 Saint James Dr
Memphis, TN 38116-7670

Mailing address

3971 Knight Arnold Rd
Memphis, TN 38118-3004
Phone (901) 869-7787

Other identifiers 1

IdentifierTypeStateIssuer
7447080MedicaidTN

Other names 1

  • St. James Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Shelby Residential and Vocational Services9 organizations share this tax ID, including this one
Part of
Shelby Residential and Vocational Services

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2115 Saint James Dr
Memphis, TN 38116
Phone (901) 332-9874

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1219276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714608000000",
    "number": "1265689293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3971 KNIGHT ARNOLD RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381183004",
            "telephone_number": "901-869-7787",
            "fax_number": "901-322-6391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 SAINT JAMES DR",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381167670",
            "telephone_number": "901-332-9874",
            "fax_number": "901-312-9906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHELBY RESIDENTIAL & VOCATIONAL SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SHELBY RESIDENTIAL & VOCATIONAL SERVICES, INC.",
        "enumeration_date": "2008-08-21",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A",
        "authorized_official_last_name": "DURBIN",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "901-821-1067"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "TN",
            "license": "L323-067-6611",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7447080",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. James",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St. James",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 2, 2024; 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.