Individual provider Active NPI

Phillip R Langsdon, MD

  • Facial Plastic Surgery Physician
  • Memphis, TN
National Provider Identifier
1396701413
Registry record updated Dec 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X
License
16885 Issued in TN
Practice address
1910 Nonconnah Blvd
Suite 120
Memphis, TN 38132-2113
Phone
(901) 448-2300
Fax
(901) 448-6657
NPI assigned
Apr 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Facial Plastic Surgery Physician 207YS0123X 16885 TN Primary

Addresses

Primary practice location

1910 Nonconnah Blvd
Suite 120
Memphis, TN 38132-2113

Mailing address

66 N Pauline St
Suite 206
Memphis, TN 38105-5105
Phone (901) 448-7642

Other identifiers 1

IdentifierTypeStateIssuer
3021123MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Phillip R. Langsdon MD Facs PLLC PastSince Jul 1, 2002 Accepting new patients
Germantown Ambulatory Surgical LLC PastSince Feb 1, 1993 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196899200000",
    "number": "1396701413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 N PAULINE ST",
            "address_2": "SUITE 206",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381055105",
            "telephone_number": "901-448-7642",
            "fax_number": "901-448-8015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 NONCONNAH BLVD",
            "address_2": "SUITE 120",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381322113",
            "telephone_number": "901-448-2300",
            "fax_number": "901-448-6657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANGSDON",
        "first_name": "PHILLIP",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2007-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "TN",
            "license": "16885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3021123",
            "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 Dec 6, 2007; 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.