Organization Active NPI

Radiant Life Healthcare PC

  • Internal Medicine Physician
  • Memphis, TN
National Provider Identifier
1407615677
Registry record updated Mar 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
RADIANT LIFE HEALTHCARE PC
Practice address
333 S Bellevue Blvd
Memphis, TN 38104-3530
Phone
(901) 729-2708
Fax
(901) 729-2720
NPI assigned
Mar 18, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2024

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

Authorized official

Name
Dr. Russell D Beis, MD
Title
Medical Director
Phone
(901) 582-4059

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

333 S Bellevue Blvd
Memphis, TN 38104-3530

Mailing address

1072 Wedgewood St
Memphis, TN 38111-8138
Phone (901) 582-4059

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1710720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710720000000",
    "number": "1407615677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1072 WEDGEWOOD ST",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381118138",
            "telephone_number": "901-582-4059",
            "fax_number": "901-726-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 S BELLEVUE BLVD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381043530",
            "telephone_number": "901-729-2708",
            "fax_number": "901-729-2720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIANT LIFE HEALTHCARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-18",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A",
        "authorized_official_last_name": "BEIS",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "901-582-4059",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "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 Mar 18, 2024; 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.