Organization Active NPI

Wesley Neurology Clinic PC

  • Neurology Physician
  • Memphis, TN
National Provider Identifier
1437101821
Registry record updated Sep 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
WESLEY NEUROLOGY CLINIC PC
Practice address
1211 Union Ave
Ste 400
Memphis, TN 38104
Phone
(901) 725-8920
Fax
(901) 725-8936
NPI assigned
May 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2008

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

Authorized official

Name
Mr. James R Lucas
Title
Administrator
Phone
(901) 725-8920

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X Primary

Addresses

Primary practice location

1211 Union Ave
Ste 400
Memphis, TN 38104

Mailing address

PO Box 1885
Memphis, TN 38101-1885
Phone (901) 725-8920

Other identifiers 3

IdentifierTypeStateIssuer
3703205MedicaidTN
09013571MedicaidMS
122543002MedicaidAR

National Provider Directory

National Provider Directory

Locations

8000 Centerview Pkwy
Ste 305
Cordova, TN 38018
Phone (901) 261-3500

7655 Poplar Ave
Ste 155
Germantown, TN 38138
Phone (901) 261-3500

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": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222387200000",
    "number": "1437101821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1885",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381011885",
            "telephone_number": "901-725-8920",
            "fax_number": "901-725-8936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 UNION AVE",
            "address_2": "STE 400",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38104",
            "telephone_number": "901-725-8920",
            "fax_number": "901-725-8936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESLEY NEUROLOGY CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-16",
        "last_updated": "2008-09-26",
        "status": "A",
        "authorized_official_last_name": "LUCAS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "901-725-8920",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3703205",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09013571",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122543002",
            "state": "AR"
        }
    ],
    "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 Sep 26, 2008; 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.