NPIMap

Organization Active NPI

Omni Community Health

  • Community/Behavioral Health Agency
  • Memphis, TN
National Provider Identifier
1316320880
Registry record updated Sep 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
OMNI COMMUNITY HEALTH
Practice address
1407 Union Ave
Suite 815
Memphis, TN 38104-3679
Phone
(901) 800-4645
Fax
(901) 729-6377
NPI assigned
Jul 2, 2015
Last updated
Sep 2, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2020

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

Authorized official

Name
Mark Just
Title
Chief Executive Officer
Phone
(615) 726-3603

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

1407 Union Ave
Suite 815
Memphis, TN 38104-3679

Mailing address

301 S Perimeter Park Drive
Suite 210
Nashville, TN 37211-4128
Phone (615) 726-3603

Other identifiers 2

IdentifierTypeStateIssuer
3376955MedicaidTN
Q019918MedicaidTN

National Provider Directory

National Provider Directory
Tax ID family
Omni Community Health Inc11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Locations

1407 Union Ave
Ste 100
Memphis, TN 38104
Phone (615) 726-3603

1407 Union Ave
Ste 815
Memphis, TN 38104
Phone (901) 800-4645

Practitioners & affiliated clinicians

Practitioners 4

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": "1435795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599004800000",
    "number": "1316320880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 S PERIMETER PARK DRIVE",
            "address_2": "SUITE 210",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372114128",
            "telephone_number": "615-726-3603",
            "fax_number": "615-827-0421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1407 UNION AVE",
            "address_2": "SUITE 815",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381043679",
            "telephone_number": "901-800-4645",
            "fax_number": "901-729-6377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMNI COMMUNITY HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-02",
        "last_updated": "2020-09-02",
        "certification_date": "2020-09-02",
        "status": "A",
        "authorized_official_last_name": "JUST",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "615-726-3603"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3376955",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q019918",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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, 2020; 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.