NPIMap

Organization Active NPI

University of Memphis

  • Behavior Analyst
  • Memphis, TN
National Provider Identifier
1427603554
Registry record updated Aug 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
UNIVERSITY OF MEMPHIS
Practice address
4055 North Park Loop
Suite 1000
Memphis, TN 38152
Phone
(901) 678-3209
Fax
(901) 678-5630
NPI assigned
Aug 6, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2019

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

Authorized official

Name
Mr. William Mueller
Title
Interim Executive Director Procurem
Phone
(901) 678-5348

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X Primary
Counseling PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC1900X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X

Addresses

Primary practice location

4055 North Park Loop
Suite 1000
Memphis, TN 38152

Mailing address

4055 North Park Loop
Suite 1000
Memphis, TN 38152
Phone (901) 678-3209

Other names 1

  • Interprofessional Community Health Clinic Other name

National Provider Directory

National Provider Directory
Tax ID family
The University of Memphis5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4055 N Park Loop
Ste 1000
Memphis, TN 38152
Phone (320) 990-1678

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1565049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565049600000",
    "number": "1427603554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4055 NORTH PARK LOOP",
            "address_2": "SUITE 1000",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38152",
            "telephone_number": "901-678-3209",
            "fax_number": "901-678-5630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4055 NORTH PARK LOOP",
            "address_2": "SUITE 1000",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38152",
            "telephone_number": "901-678-3209",
            "fax_number": "901-678-5630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF MEMPHIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-06",
        "last_updated": "2019-08-06",
        "status": "A",
        "authorized_official_last_name": "MUELLER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "INTERIM EXECUTIVE DIRECTOR PROCUREM",
        "authorized_official_telephone_number": "901-678-5348",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Interprofessional Community Health Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Aug 6, 2019; 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.