Individual provider Active NPI

Gayle Minard, MD

  • Trauma Surgery Physician
  • Memphis, TN
National Provider Identifier
1427014695
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Trauma Surgery PhysicianTaxonomy code 2086S0127X
License
19794 Issued in TN
Practice address
1910 Nonconnah Blvd
Suite 120
Memphis, TN 38132-2113
Phone
(901) 448-2300
Fax
(901) 448-6657
NPI assigned
Apr 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Trauma Surgery Physician 2086S0127X 19794 TN Primary

Addresses

Primary practice location

1910 Nonconnah Blvd
Suite 120
Memphis, TN 38132-2113

Mailing address

66 N Pauline St
Suite 206
Memphis, TN 38105-5105
Phone (901) 448-7642

Other identifiers 1

IdentifierTypeStateIssuer
3060430MedicaidTN

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

NPI Registry JSON

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1427014695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 N PAULINE ST",
            "address_2": "SUITE 206",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381055105",
            "telephone_number": "901-448-7642",
            "fax_number": "901-448-8015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 NONCONNAH BLVD",
            "address_2": "SUITE 120",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381322113",
            "telephone_number": "901-448-2300",
            "fax_number": "901-448-6657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINARD",
        "first_name": "GAYLE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-25",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "TN",
            "license": "19794",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3060430",
            "state": "TN"
        }
    ],
    "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 Jul 9, 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.

Verify at the official NPI Registry.