Individual provider Active NPI

Christopher Anthony Witherspoon, MD

  • Sports Medicine (Family Medicine) Physician
  • Memphis, TN
National Provider Identifier
1295730786
Registry record updated Dec 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
62514 Issued in TN
Practice address
6305 Humphreys Blvd Ste 101
Memphis, TN 38120-2372
Phone
(901) 227-8930
Fax
(901) 227-8936
NPI assigned
Jun 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X K2828 TX
Sports Medicine (Family Medicine) Physician 207QS0010X K2828 TX
Sports Medicine (Family Medicine) Physician 207QS0010X 62514 TN Primary

Addresses

Primary practice location

6305 Humphreys Blvd Ste 101
Memphis, TN 38120-2372

Mailing address

965 Ridge Lake Blvd Ste 315
Memphis, TN 38120-9401

Other practice location 1

6257 Fm 2642 Blvd Ste 100
Royse City, TX 75189-3224
Phone (469) 800-2180

Other identifiers 3

IdentifierTypeStateIssuer
168601601MedicaidTX
168601605MedicaidTX
168601602MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211220001365 TN Practitioner - Sports MedicinePractitioner - Family Practice 2668453747 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
81.87 of 100Reported as group
Quality
64.75
Promoting interoperability
100
Improvement activities
40
Cost
74.81

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
62514TNMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Les T. Sandknop, D.O. PA Family Medicine CurrentSince Sep 10, 2006 Accepting new patients
Baptist Memorial Medical Group Inc Family Medicine CurrentSince Jan 1, 2022 Accepting new patients
Baptist Memorial Medical Group Inc CurrentSince Jan 1, 2022 Accepting new patients
Physician Associates of Southwest Dallas Family Medicine Past Accepting new patients
Accent Family Health Care LLC Family Medicine Past Accepting new patients
Baptist Memorial Health Services, Inc. of Mississippi Past Accepting new patients

Locations

36 Capital Way
Ste E
Atoka, TN 38004
Phone (901) 837-6801

8138 Country Village Dr
Cordova, TN 38016
Phone (901) 725-8606

6305 Humphreys Blvd
Ste 101
Memphis, TN 38120
Phone (901) 227-8930

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

6305 Humphreys Blvd
Ste 108
Memphis, TN 38120
Phone (901) 227-8930

965 Ridge Lake Blvd
Ste 315
Memphis, TN 38120
Phone (877) 348-1281

4315 Ridgecrest Rd
Greenville, TX 75402
Phone (903) 450-4788

6785 Horizon Rd
Ste 100
Heath, TX 75032
Phone (972) 771-9000

1005 W Ralph Hall Pkwy
Ste 221
Rockwall, TX 75032
Phone (972) 771-9000

Interoperability endpoints

  • Direct secure messaging: cwitherspoon494356@direct.bmhcc.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1295730786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 RIDGE LAKE BLVD STE 315",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209401",
            "fax_number": "901-227-8591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6305 HUMPHREYS BLVD STE 101",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202372",
            "telephone_number": "901-227-8930",
            "fax_number": "901-227-8936"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6257 Fm 2642 Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Royse City",
            "state": "TX",
            "postal_code": "751893224",
            "country_code": "US",
            "telephone_number": "469-800-2180",
            "fax_number": "469-800-2190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WITHERSPOON",
        "first_name": "CHRISTOPHER",
        "middle_name": "ANTHONY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-20",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K2828",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "TX",
            "license": "K2828",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "TN",
            "license": "62514",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "168601601",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "168601605",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "168601602",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.