NPIMap

Organization Active NPI

West Clinic, PC

  • Psychologist
  • Memphis, TN
National Provider Identifier
1396765608
Registry record updated Jan 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
WEST CLINIC, PC
Practice address
100 N Humphreys Blvd
Memphis, TN 38120-2146
Phone
(901) 683-0055
Fax
(901) 685-2969
NPI assigned
Jul 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2008

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

Authorized official

Name
Mr. Steve M Coplon
Title
Ceo
Phone
(901) 683-0055

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

100 N Humphreys Blvd
Memphis, TN 38120-2146

Mailing address

100 N Humphreys Blvd
Memphis, TN 38120-2146
Phone (901) 683-0055

Other identifiers 2

IdentifierTypeStateIssuer
3704066MedicaidTN
3704067MedicaidTN

Other names 1

  • West Clinic PhD's Other name

National Provider Directory

National Provider Directory
Tax ID family
The West Clinic PC38 organizations share this tax ID, including this one

Other organizations with this tax ID 37

Organizations that report the same tax identification number in the National Provider Directory.

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200268800000",
    "number": "1396765608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N HUMPHREYS BLVD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202146",
            "telephone_number": "901-683-0055",
            "fax_number": "901-685-2969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N HUMPHREYS BLVD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202146",
            "telephone_number": "901-683-0055",
            "fax_number": "901-685-2969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST CLINIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-20",
        "last_updated": "2008-01-14",
        "status": "A",
        "authorized_official_last_name": "COPLON",
        "authorized_official_first_name": "STEVE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "901-683-0055",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3704066",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3704067",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Clinic PhD's",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Jan 14, 2008; 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.