NPIMap

Organization Active NPI

Support Solutions of the Mid-South

  • Community/Behavioral Health Agency
  • Memphis, TN
National Provider Identifier
1407025539
Registry record updated Jan 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
L3(20)4M4-038-6644 Issued in TN
Legal business name
SUPPORT SOLUTIONS OF THE MID-SOUTH
Practice address
5909 Shelby Oaks Dr
Suite 100
Memphis, TN 38134-7317
Phone
(901) 383-9193
Fax
(901) 383-9195
NPI assigned
Feb 22, 2008
Last updated
Jan 7, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2010

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

Authorized official

Name
Dr. Larry Durbin, EDD
Title
Chief Executive Officer
Phone
(901) 383-9193

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X PSS0000000274 TN
Community/Behavioral Health Agency 251S00000X L3(20)4M4-038-6644 TN Primary

Addresses

Primary practice location

5909 Shelby Oaks Dr
Suite 100
Memphis, TN 38134-7317

Mailing address

5909 Shelby Oaks Dr
Suite 100
Memphis, TN 38134-7317
Phone (901) 383-9193

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120214000467 TN Part B Supplier - Clinic/Group Practice 0446418834 Receives reassigned benefits from 8 practitioners
Practice locations: Bolivar, TN; Nashville, TN; Memphis, TN; Knoxville, TN; Jackson, TN; Greeneville, TN; Chattanooga, TN

National Provider Directory

National Provider Directory

Locations

518 Pecan Dr
Bolivar, TN 38008
Phone (731) 658-9797

105 Lee Parkway Dr
Ste I
Chattanooga, TN 37421
Phone (423) 499-4492

1007 W Main St
Ste B
Greeneville, TN 37743
Phone (423) 636-0930

250 N Parkway
Ste 25
Jackson, TN 38305
Phone (731) 660-8500

318 Nancy Lynn Ln
Ste 18AND21
Knoxville, TN 37919
Phone (865) 558-0930

1410 Donelson Pike
Ste B17
Nashville, TN 37217
Phone (615) 263-4425

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1203638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262822400000",
    "number": "1407025539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5909 SHELBY OAKS DR",
            "address_2": "SUITE 100",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381347317",
            "telephone_number": "901-383-9193",
            "fax_number": "901-383-9195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5909 SHELBY OAKS DR",
            "address_2": "SUITE 100",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381347317",
            "telephone_number": "901-383-9193",
            "fax_number": "901-383-9195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPPORT SOLUTIONS OF THE MID-SOUTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-22",
        "last_updated": "2010-01-07",
        "status": "A",
        "authorized_official_last_name": "DURBIN",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "901-383-9193",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "EDD"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "TN",
            "license": "PSS0000000274",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "TN",
            "license": "L3(20)4M4-038-6644",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jan 7, 2010; 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.