NPIMap

Organization Active NPI

Tri State Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Memphis, TN
National Provider Identifier
1285002634
Registry record updated Jun 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
TRI STATE COMMUNITY HEALTH CENTER
Practice address
4041 Knight Arnold Rd
Suite 100
Memphis, TN 38118-2128
Phone
(901) 360-0442
Fax
(901) 360-0865
NPI assigned
Sep 2, 2015
Last updated
Jun 8, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2026

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

Authorized official

Name
Albert L Richardson
Title
Chief Executive Officer
Phone
(901) 360-0442

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

4041 Knight Arnold Rd
Suite 100
Memphis, TN 38118-2128

Mailing address

4041 Knight Arnold Rd
Suite 100
Memphis, TN 38118-2128
Phone (901) 360-0442

Other practice location 1

3839 LaMar Ave
Memphis, TN 38118-3706
Phone (901) 505-0402

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20151217001928 TN Part B Supplier - Clinic/Group Practice 4486955341 Receives reassigned benefits from 33 practitioners
Practice locations: Memphis, TN
O20160303002029 TN Part A Provider - Federally Qualified Health Center (FQHC) 4486955341 Practice locations: Memphis, TN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1285002634. Details of each certification follow.

Federally qualified health center certification: CCN 441971

Legal name
TRI STATE COMMUNITY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 3, 2016
Last certification
Mar 3, 2016
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
4041 Knight Arnold Rd
Memphis, TN 38118-2128

National Provider Directory

National Provider Directory
Tax ID family
Tri St Community HLTH CNTR2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

3839 Lamar Ave
Memphis, TN 38118
Phone (901) 360-0442

4041 Knight Arnold Rd
Memphis, TN 38118
Phone (901) 572-1573

4041 Knight Arnold Rd
#100
Memphis, TN 38118
Phone (901) 360-0442

4041 Knight Arnold Rd
#300
Memphis, TN 38118

4041 Knight Arnold Rd
Ste 300
Memphis, TN 38118

Ownership & related parties

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Albert Richardson Individual Contracted Managing EmployeeCeo Mar 1, 2024 100%
Corporate OfficerCeo Sep 2, 2015
Corporate DirectorCeo Mar 1, 2024 100%

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 34

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 34

NPI Registry JSON

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

{
    "created_epoch": "1441152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780876800000",
    "number": "1285002634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4041 KNIGHT ARNOLD RD",
            "address_2": "SUITE 100",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381182128",
            "telephone_number": "901-360-0442",
            "fax_number": "901-360-0865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4041 KNIGHT ARNOLD RD",
            "address_2": "SUITE 100",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381182128",
            "telephone_number": "901-360-0442",
            "fax_number": "901-360-0865"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3839 LaMar Ave",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381183706",
            "country_code": "US",
            "telephone_number": "901-505-0402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TRI STATE COMMUNITY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-02",
        "last_updated": "2026-06-08",
        "certification_date": "2026-06-08",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "ALBERT",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "901-360-0442"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.