Active NPI
Constance L Durbin, MD
- Child & Adolescent Psychiatry Physician
- Cordova, TN
National Provider Identifier
1407963515
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- 015847
- Practice address
- 1135 Cully Rd
Ste 100
Cordova, TN 38016 - Phone
- (901) 758-1980
- Fax
- (901) 309-8784
- NPI assigned
- Aug 24, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | 015847 | TN | Primary |
Addresses
Primary practice location
1135 Cully Rd
Ste 100
Cordova, TN 38016
Mailing address
PO Box 1000
Box 213
Memphis, TN 38148
Phone (901) 758-1980
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3088651 | Medicaid | TN |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 015847 | TN | MD | Child & Adolescent Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Tennessee | Past | Accepting new patients | |
| Child & Adolescent Psychiatry Associates | Child & Adolescent Psychiatry | Past | 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.
-
- Child & Adolescent Psychiatry Physician
- Cordova, TN
- NPI 1588769442
-
dba Center on Developmental Disabilities
- Developmental Disabilities Clinic/Center
- Memphis, TN
- NPI 1427064880
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1407963515",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1000",
"address_2": "BOX 213",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "38148",
"telephone_number": "901-758-1980",
"fax_number": "901-309-8784"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1135 CULLY RD",
"address_2": "STE 100",
"city": "CORDOVA",
"state": "TN",
"postal_code": "38016",
"telephone_number": "901-758-1980",
"fax_number": "901-309-8784"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DURBIN",
"first_name": "CONSTANCE",
"middle_name": "L",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "TN",
"license": "015847",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3088651",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cordova, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.