NPIMap

Organization Active NPI

Sam Delk

Doing business as Sam Delk MD

  • Surgery Physician
  • Memphis, TN
National Provider Identifier
1275567349
Registry record updated Sep 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
37329 Issued in TN
Legal business name
SAM DELK
Doing business as
Sam Delk MD
Practice address
176 S Bellevue Blvd
Suite 505
Memphis, TN 38104-3417
Phone
(901) 725-0421
Fax
(901) 278-4675
NPI assigned
Jul 11, 2006
Last updated
Sep 2, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2022

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

Authorized official

Name
Dr. Sam Delk, M.D.NPI 1922026707
Title
Owner/M.D.
Phone
(901) 725-0421

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 37329 TN Primary

Addresses

Primary practice location

176 S Bellevue Blvd
Suite 505
Memphis, TN 38104-3417

Mailing address

PO Box 126
Memphis, TN 38101-0126
Phone (901) 757-2345

Other identifiers 3

IdentifierTypeStateIssuer
3003101MedicaidTN
114202001MedicaidAR
0037329OtherTNBLUE CROSS BLUE SHIELD

Other names 1

  • SAM DELK MD Doing business as

National Provider Directory

National Provider Directory

Locations

176 S Bellevue Blvd
Ste 505
Memphis, TN 38104
Phone (901) 725-0421

Practitioners & affiliated clinicians

Practitioners 2

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": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662076800000",
    "number": "1275567349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 126",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381010126",
            "telephone_number": "901-757-2345",
            "fax_number": "901-757-9065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 S BELLEVUE BLVD",
            "address_2": "SUITE 505",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381043417",
            "telephone_number": "901-725-0421",
            "fax_number": "901-278-4675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAM DELK",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2022-09-02",
        "certification_date": "2022-09-02",
        "status": "A",
        "authorized_official_last_name": "DELK",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "OWNER/M.D.",
        "authorized_official_telephone_number": "901-725-0421",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "TN",
            "license": "37329",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3003101",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114202001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0037329",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SAM DELK MD",
            "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 2, 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.