Memphis Dermatology Clinic PA

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

MEMPHIS DERMATOLOGY CLINIC PA

Practice address

1455 Union Ave
Memphis, TN 38104-6727

Phone

(901) 726-6655

Fax

(901) 726-9056

NPI assigned

Feb 14, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Lynn Harris

Title

Administrative Assistant

Phone

(901) 726-6655

Specialties & licenses 1

Addresses

Other names 1

• Professional Association Other name

Medicare fee-for-service enrollment

Enrolled in TN2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Frances Beard, MD

  • Dermatopathology Physician
  • Memphis, TN
  • NPI 1770550659

  Mohs-Micrographic Surgery

  Medicare reassignment Care Compare group NPD
• Alexandra Dee Maxted Chantara, M.D.

  • Dermatology Physician
  • Memphis, TN
  • NPI 1679937999
  Medicare reassignment Care Compare group NPD
• Robin H Friedman-Musicante, MD

  • Dermatopathology Physician
  • Memphis, TN
  • NPI 1700853520

  Mohs-Micrographic Surgery

  Medicare reassignment Care Compare group NPD
• Leslie Elaine Graham, DNP, AGNP-C

  • Nurse Practitioner
  • Memphis, TN
  • NPI 1215733050
  Medicare reassignment Care Compare group NPD
• Amy A Huber, MD

  • MOHS-Micrographic Surgery Physician
  • Memphis, TN
  • NPI 1215904602
  Medicare reassignment Care Compare group NPD
• Frances Kirkland Lawhead, MD

  • Dermatopathology Physician
  • Memphis, TN
  • NPI 1992927214

  Dermatology

  Medicare reassignment Care Compare group NPD
• Emily T. Overholser, M.D.

  • Dermatology Physician
  • Memphis, TN
  • NPI 1073824561
  Medicare reassignment Care Compare group NPD
• Mary Elizabeth Stephens, NP-C

  • Family Nurse Practitioner
  • Memphis, TN
  • NPI 1356836076
  Medicare reassignment Care Compare group NPD
• Courtney Stroupe Woodmansee, MD

  • MOHS-Micrographic Surgery Physician
  • Memphis, TN
  • NPI 1134346430

  Dermatology

  Medicare reassignment Care Compare group NPD
• Rachel Carson Doerr, APRN

  • Nurse Practitioner
  • Tallahassee, FL
  • NPI 1023531506

  TN

  Medicare reassignment Care Compare group NPD
• Buckley Parker, P.A.-C

  • Physician Assistant
  • Memphis, TN
  • NPI 1700266558
  Medicare reassignment Care Compare group
• John Harvey Gardner, MD

  • MOHS-Micrographic Surgery Physician
  • Memphis, TN
  • NPI 1669445276
  NPD

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713139200000",
    "number": "1366416653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1455 UNION AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381046727",
            "telephone_number": "901-726-6655",
            "fax_number": "901-726-9056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 UNION AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381046727",
            "telephone_number": "901-726-6655",
            "fax_number": "901-726-9056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMPHIS DERMATOLOGY CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-14",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-15",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "LYNN",
        "authorized_official_title_or_position": "ADMINISTRATIVE ASSISTANT",
        "authorized_official_telephone_number": "901-726-6655",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Professional Association",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Memphis Children'S Surgery Center, LLC
• Memphis Chiropractic Group
• Memphis Clinical Laboratory Inc
• Memphis Clinics LLC
• Memphis Community Health & Wellness Clinic, PLLC
• Memphis DME Supply LLC
• Memphis Electrocardiographic Physicians PLLC
• Memphis Emergency Dental
• Memphis Endodontics, PLC
• Memphis Eye & Cataract Associates PLC

• Dermatology Physician in Memphis, TN
• Providers in Memphis, TN by specialty
• Dermatology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.