Bartlett- Raleigh Internal Medicine Group, P. C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

N/A Issued in TN

Legal business name

BARTLETT- RALEIGH INTERNAL MEDICINE GROUP, P. C.

Practice address

8357 Memphis Arlington Rd
Bartlett, TN 38133-2138

Phone

(901) 210-6197

Fax

(901) 383-1178

NPI assigned

Jun 9, 2006

Last updated

Jul 23, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Herminio B Balderama, M.D.NPI 1861433377

Title

President

Phone

(901) 210-6197

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 2

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.

• Herminio B Balderama, M.D.

  • Internal Medicine Physician
  • Bartlett, TN
  • NPI 1861433377
  Authorized official Same address or phone
• Forrest C Ward, M.D.

  • Internal Medicine Physician
  • Bartlett, TN
  • NPI 1578507661
  NPD

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626998400000",
    "number": "1386685246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8357 MEMPHIS ARLINGTON RD",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381332138",
            "telephone_number": "901-371-0200",
            "fax_number": "901-383-1178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8357 MEMPHIS ARLINGTON RD",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381332138",
            "telephone_number": "901-210-6197",
            "fax_number": "901-383-1178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BARTLETT- RALEIGH INTERNAL MEDICINE GROUP, P. C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-09",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A",
        "authorized_official_last_name": "BALDERAMA",
        "authorized_official_first_name": "HERMINIO",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "901-210-6197",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "N/A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3702480",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "123821",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Nikeisha Bass, LCSW
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• Internal Medicine Physician in Bartlett, TN
• Providers in Bartlett, TN by specialty
• Internal Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2021; 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.