Baptist Memorial Medical Group Inc
Organization Active NPI Internal Medicine Physician · Memphis, TN
NPI 1306089206 · NPPES record last updated Oct 8, 2020
Key facts
- NPI
- 1306089206
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- Legal business name
- BAPTIST MEMORIAL MEDICAL GROUP INC
- Practice address
- 8970 Winchester Rd
Memphis, TN 38125-8231 - Phone
- (901) 227-4068
- NPI assigned
- Apr 8, 2009
- Organization subpart
- Yes
- Parent organization (as reported)
- BAPTIST MEMORIAL HEALTH CARE CORP.
Authorized official
- Name
- Gregory M Duckett
- Title
- Sr VP/Clo
- Phone
- (901) 227-5233
Other NPIs with the same Medicare PAC ID 3
Practitioners 865
-
Ahmad Bashar Abdulkarim, MD, PHD
-
Leah Ifeoluwa Akinseye, M.D.
-
Abdullah Al-Rashdan, M.D.
-
Robert Alejo Armada, D.O.
-
Monam Bashir Awan, M.D.
-
Anita Lynn Baker-Ross, APN, CNM
-
Gala Markia Barden, M.D.
-
James Calvin Beasley Jr., DNP AG-ACNP-BC, FNP-
-
Neal S Beckford, M.D.
-
Jessica Estelle Bell, M.D.
-
Prashanth Bhat, M.D.
-
Muhammad F Bilal, MD
-
Denisha Renee Blacher, APRN
-
Linda Marie Bowen, AGACNP-BC
-
Amber Nicole Bradley, FNP
-
Bruce B Brown, M.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 25D0320290 | Baptist Memorial Medical Group Inc - Ma | Certificate of waiver | Apr 30, 2028 |
| 44D0314193 | Baptist Memorial Medical Group Inc-FHFP | Certificate of waiver | Jun 6, 2027 |
| 44D0315382 | Baptist Memorial Medical Group Inc-Ucdc | Compliance | Oct 27, 2026 |
| 44D0887663 | Baptist Memorial Medical Group, Inc-Bumc | Certificate of waiver | Dec 31, 2026 |
| 44D1103588 | Baptist Memorial Medical Group, Inc | Certificate of waiver | Aug 12, 2027 |
| 44D2334990 | Baptist Memorial Medical Group, Inc-TFM | Certificate of waiver | Dec 3, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in TN, MS, AR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040218000385 | TN | Part B Supplier - Clinic/Group Practice | 5193610228 |
Receives reassigned benefits from 592 practitioners 12 other NPIs on this enrollment |
| O20101011000028 | MS | Part B Supplier - Clinic/Group Practice | 5193610228 | Receives reassigned benefits from 481 practitioners |
| O20151202001309 | AR | Part B Supplier - Clinic/Group Practice | 5193610228 |
Receives reassigned benefits from 92 practitioners Practice locations: Jonesboro, AR; Marion, AR; West Memphis, AR |
National Provider Directory
- Part of
- Baptist Memorial Health Care Corp
Locations (25 of 62)
416 E Washington Ave
Ste D
Jonesboro, AR 72401
Phone (501) 933-8740
100 Hospital St
#300
Booneville, MS 38829
Phone (662) 728-2147
100 Hospital St
Ste 300
Booneville, MS 38829
Phone (601) 728-2147
202 N 1st St
Ste 2
Booneville, MS 38829
100 Hospital St
Ste 200
Booneville, MS 38829
Phone (662) 720-3000
202 N 1st St
Booneville, MS 38829
Phone (662) 340-1138
2104 5th St N
Columbus, MS 39705
Phone (662) 244-1705
255 Baptist Blvd
Ste 402
Columbus, MS 39705
Phone (662) 240-1412
2102 5th St N
Ste 1
Columbus, MS 39705
Phone (662) 244-2550
3700 N Frontage Rd
Columbus, MS 39701
Phone (205) 330-8820
255 Baptist Blvd
Ste 202
Columbus, MS 39705
520 Willowbrook Rd
Columbus, MS 39705
Phone (662) 240-1412
300 Oxford Rd
New Albany, MS 38652
Phone (601) 534-8166
200 State Highway 30 W
Ste 100
New Albany, MS 38652
Phone (662) 538-2680
100 Baptist Memorial Cir
Ste 3
Oxford, MS 38655
504 Azalea Dr
Ste B
Oxford, MS 38655
Phone (662) 636-4250
81 Ed Perry Blvd
Ste 107
Oxford, MS 38655
Phone (662) 636-5290
504 Azalea Dr
Ste A
Oxford, MS 38655
Phone (662) 236-7738
100 Baptist Memorial Cir
Ste 120
Oxford, MS 38655
Phone (662) 244-2288
7165 Getwell Rd
Bldg F
Southaven, MS 38672
Phone (662) 349-3206
363 Southcrest Cir
Ste 101
Southaven, MS 38671
Phone (662) 349-0755
401 Southcrest Cir
Ste 201
Southaven, MS 38671
Phone (662) 772-4000
401 Southcrest Cir
Ste 202
Southaven, MS 38671
Phone (662) 536-2281
401 Southcrest Cir
Ste 210
Southaven, MS 38671
Phone (662) 536-1944
105 Doctors Park
Starkville, MS 39759
Phone (662) 324-1310
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | |||
| Internal Medicine Physician |
207R00000X | Yes | ||
| Hematology & Oncology Physician |
207RH0003X | |||
| Neurological Surgery Physician |
207T00000X | |||
| Obstetrics & Gynecology Physician |
207V00000X | |||
| Pediatrics Physician |
208000000X | |||
| Physical Medicine & Rehabilitation Physician |
208100000X | |||
| Psychiatry Physician |
2084P0800X | |||
| Radiation Oncology Physician |
2085R0001X | |||
| Surgery Physician |
208600000X | |||
| Surgical Oncology Physician |
2086X0206X | |||
| Urology Physician |
208800000X | |||
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
208G00000X | |||
| Hospitalist Physician |
208M00000X | |||
| Nurse Practitioner |
363L00000X |
Addresses
Primary practice location
8970 Winchester Rd
Memphis, TN 38125-8231
Mailing address
350 N Humphreys Blvd
Memphis, TN 38120-2177
Other practice location 1
100 Baptist Memorial Cir Ste 200
Oxford, MS 38655-4476
Phone (662) 244-2288
Other practice location 2
100 Baptist Memorial Cir Ste 120
Oxford, MS 38655-4476
Phone (662) 244-2288
Other practice location 3
100 Baptist Memorial Cir Ste 202
Oxford, MS 38655-4476
Phone (662) 636-2451
Other practice location 4
100 Baptist Memorial Cir Ste 204
Oxford, MS 38655-4476
Phone (662) 636-4333
Other practice location 5
104 Doctors Park
Starkville, MS 39759-2570
Phone (662) 323-1181
Other practice location 6
107 Brandon Rd
Starkville, MS 39759-2521
Phone (662) 240-1412
Other practice location 7
107 Brandon Rd
Starkville, MS 39759-2521
Phone (662) 240-1412
Other practice location 8
1109 E Reelfoot Ave Ste F
Union City, TN 38261-5867
Phone (731) 884-1412
Other practice location 9
1111 Union Ave
Memphis, TN 38104-6646
Phone (901) 529-4045
Other practice location 10
1205 Russell St
Union City, TN 38261-5352
Phone (731) 884-0002
Other practice location 11
1300 Sunset Dr Ste Q
Grenada, MS 38901-4084
Phone (662) 294-9101
Other practice location 12
1312 Bishop St
Union City, TN 38261-5406
Phone (731) 885-5100
Other practice location 13
1412 E Reelfoot Ave
Union City, TN 38261-5813
Phone (731) 885-5131
Other practice location 14
1500 W Poplar Ave Ste 206
Collierville, TN 38017-0601
Phone (901) 861-8484
Other practice location 15
1500 W Poplar Ave Ste 202
Collierville, TN 38017-0601
Phone (901) 861-9090
Other practice location 16
1500 W Poplar Ave Ste 308
Collierville, TN 38017-0601
Phone (901) 861-8550
Other practice location 17
1500 W Poplar Ave
Collierville, TN 38017-0601
Phone (901) 226-2800
Other practice location 18
1520 Union Ave
Memphis, TN 38174-0275
Phone (901) 757-3439
Other practice location 19
1522 N Division St
Blytheville, AR 72315-1448
Phone (870) 762-1660
Other practice location 20
1700 Woodlawn Ave
Dyersburg, TN 38024-2028
Phone (731) 259-6289
Other practice location 21
1995 Highway 51 S Ste 203
Covington, TN 38019-3655
Phone (901) 475-5480
Other practice location 22
1995 Highway 51 S Ste 204
Covington, TN 38019-3655
Phone (901) 475-5305
Other providers in Memphis, TN
- Baptist Memorial Hospital
- Baptist Memorial Hospital
- Baptist Memorial Hospital
- Baptist Memorial Hospital-Tipton
- Baptist Memorial Medical Group Inc
- Baptist Memorial Medical Group Inc
- Baptist Memorial Regional Rehabilitation Services Inc
- Baptist Memorial Regional Rehabilitative Services Inc
- Baptist Minor Medical Centers Inc
- Baptist-Emsc LP
All providers in Memphis, TN · Internal Medicine Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 8, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.