NPIMap

Organization Active NPI

Adult Primary Care of Memphis PC

  • Internal Medicine Physician
  • Memphis, TN
National Provider Identifier
1376738906
Registry record updated Oct 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD29209 Issued in TN
Legal business name
ADULT PRIMARY CARE OF MEMPHIS PC
Practice address
6263 Poplar Ave
Suite 1052
Memphis, TN 38119-4701
Phone
(901) 761-6157
NPI assigned
Sep 6, 2007
Last updated
Oct 23, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2007

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

Authorized official

Name
Mohammad I Abutineh, M.D.NPI 1043262538
Title
Owner
Phone
(901) 761-6157

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X MD29209 TN Primary

Addresses

Primary practice location

6263 Poplar Ave
Suite 1052
Memphis, TN 38119-4701

Mailing address

PO Box 338
Memphis, TN 38101-0338
Phone (901) 761-6157

Other identifiers 1

IdentifierTypeStateIssuer
4059600OtherTNBCBS OF TN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050610000069 TN Part B Supplier - Clinic/Group Practice 7012950090 Receives reassigned benefits from 8 practitioners
Practice locations: Memphis, TN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 86

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.

View all 86

NPI Registry JSON

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

{
    "created_epoch": "1189036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193097600000",
    "number": "1376738906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 338",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381010338",
            "telephone_number": "901-761-6157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6263 POPLAR AVE",
            "address_2": "SUITE 1052",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381194701",
            "telephone_number": "901-761-6157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADULT PRIMARY CARE OF MEMPHIS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-06",
        "last_updated": "2007-10-23",
        "status": "A",
        "authorized_official_last_name": "ABUTINEH",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "901-761-6157",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD29209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TN",
            "identifier": "4059600",
            "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 Oct 23, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.