NPIMap

Organization Active NPI

Premise Health of Tennessee Medical, P.C

  • Multi-Specialty Clinic/Center
  • Memphis, TN
National Provider Identifier
1275073801
Registry record updated Sep 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
PREMISE HEALTH OF TENNESSEE MEDICAL, P.C
Doing business as
ASC Memphis Health Center
Practice address
5106 Tradeport Dr
Memphis, TN 38141-8235
Phone
(615) 000-0000
NPI assigned
Mar 1, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2022

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

Authorized official

Name
Jonathan Leizman, MD
Title
President
Phone
(216) 479-9063

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

5106 Tradeport Dr
Memphis, TN 38141-8235

Mailing address

5500 Maryland Way
Suite 400
Brentwood, TN 37027-7048

Other names 1

  • ASC Memphis Health Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Premise Health of Tennessee Medical PC45 organizations share this tax ID, including this one

Other organizations with this tax ID 44

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

View all 44

Locations

5106 Tradeport Dr
Memphis, TN 38141
Phone (901) 410-2447

NPI Registry JSON

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

{
    "created_epoch": "1488326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663200000000",
    "number": "1275073801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 MARYLAND WAY",
            "address_2": "SUITE 400",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5106 TRADEPORT DR",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381418235",
            "telephone_number": "615-000-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMISE HEALTH OF TENNESSEE MEDICAL, P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-01",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A",
        "authorized_official_last_name": "LEIZMAN",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "216-479-9063",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ASC Memphis Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ASC Memphis Health Center",
            "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 Sep 15, 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.