Organization Active NPI

Pas of Memphis, Inc.

  • Anesthesiology Physician
  • Southaven, MS
National Provider Identifier
1295904704
Registry record updated Feb 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
PAS OF MEMPHIS, INC.
Practice address
7900 Airways Blvd
Building C, Suite 2
Southaven, MS 38671-4113
Phone
(662) 349-5554
NPI assigned
Feb 28, 2008
Last updated
Feb 28, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2008

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

Authorized official

Name
Ira Andre Richardson, CRNA
Title
Owner
Phone
(662) 349-2588

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X NU Primary

Addresses

Primary practice location

7900 Airways Blvd
Building C, Suite 2
Southaven, MS 38671-4113

Mailing address

PO Box 235022
Montgomery, AL 36123-5022
Phone (334) 386-2053

Other identifiers 1

IdentifierTypeStateIssuer
09852342MedicaidMS

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1204156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204156800000",
    "number": "1295904704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 235022",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361235022",
            "telephone_number": "334-386-2053",
            "fax_number": "334-244-1830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7900 AIRWAYS BLVD",
            "address_2": "BUILDING C, SUITE 2",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386714113",
            "telephone_number": "662-349-5554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAS OF MEMPHIS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-28",
        "last_updated": "2008-02-28",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "IRA",
        "authorized_official_middle_name": "ANDRE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-349-2588",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09852342",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southaven, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2008; 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.