NPIMap

Organization Active NPI

West Clinic, PC

Doing business as Memphis Heart Clinic

  • Cardiovascular Disease Physician
  • Clarksdale, MS
National Provider Identifier
1407084668
Registry record updated Nov 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
WEST CLINIC, PC
Doing business as
Memphis Heart Clinic
Practice address
1790 Hospital Drive
Clarksdale, MS 38614-7202
Phone
(662) 349-1900
Fax
(662) 349-2443
NPI assigned
Jun 26, 2009
Last updated
Nov 10, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
WEST CLINIC,PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 10, 2011

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

Authorized official

Name
Mr. Ronald O Davis
Title
Cfo
Phone
(901) 683-0055

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X Primary

Addresses

Primary practice location

1790 Hospital Drive
Clarksdale, MS 38614-7202

Mailing address

100 N Humphreys Blvd
Memphis, TN 38120-2146
Phone (901) 309-4027

Other identifiers 1

IdentifierTypeStateIssuer
01900735MedicaidMS

Other names 1

  • Memphis Heart Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
West Clinic Astc38 organizations share this tax ID, including this one
Part of
West Clinic Astc

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": "1245974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320883200000",
    "number": "1407084668",
    "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": "901-309-4027",
            "fax_number": "901-312-2664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1790 HOSPITAL DRIVE",
            "city": "CLARKSDALE",
            "state": "MS",
            "postal_code": "386147202",
            "telephone_number": "662-349-1900",
            "fax_number": "662-349-2443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST CLINIC, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WEST CLINIC,PC",
        "enumeration_date": "2009-06-26",
        "last_updated": "2011-11-10",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "901-683-0055",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01900735",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memphis Heart Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clarksdale, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2011; 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.