PPH Medical of TN, Inc Dba

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

PPH MEDICAL OF TN, INC DBA

Practice address

4515 Poplar Ave
Ste 507
Memphis, TN 38117-7503

Phone

(901) 681-2700

NPI assigned

Jul 17, 2012

Organization subpart

No

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

Authorized official

Name

Mrs. Tonya Parson, NP

Title

Ceo

Phone

(901) 681-2700

Specialties & licenses 1

Addresses

Other names 1

• Passport Health Doing business as

Locations

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

{
    "created_epoch": "1342483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437609600000",
    "number": "1366797276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4515 POPLAR AVE",
            "address_2": "SUITE 131",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38117",
            "telephone_number": "901-681-2700",
            "fax_number": "901-681-2702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4515 POPLAR AVE",
            "address_2": "STE 507",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381177503",
            "telephone_number": "901-681-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PPH MEDICAL OF TN, INC DBA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-17",
        "last_updated": "2015-07-23",
        "status": "A",
        "authorized_official_last_name": "PARSON",
        "authorized_official_first_name": "TONYA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "901-681-2700",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Passport Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Nurse Practitioner in Memphis, TN
• Providers in Memphis, TN by specialty
• Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2015; 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.