Individual provider Active NPI

Larry Baggett

  • Podiatrist
  • Memphis, TN
National Provider Identifier
1437278397
Registry record updated Jan 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
DPM285 Issued in TN
Practice address
3794 Park Ave
Memphis, TN 38111-6649
Phone
(901) 323-7970
Fax
(901) 323-0061
NPI assigned
Mar 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X DPM285 TN Primary

Addresses

Primary practice location

3794 Park Ave
Memphis, TN 38111-6649

Mailing address

3794 Park Ave
Memphis, TN 38111-6649
Phone (901) 323-7970

Other identifiers 1

IdentifierTypeStateIssuer
3351088MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100914000339 TN Practitioner - Podiatry 3274658315 Practice locations: Memphis, TN

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3794 Park Ave
Memphis, TN 38111-6649
Phone (901) 323-7970

3794 Park Aveue
Memphis, TN 38111-6649

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue128

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
DPM285TNMDPodiatrist

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548201600000",
    "number": "1437278397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3794 PARK AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381116649",
            "telephone_number": "901-323-7970",
            "fax_number": "901-323-0061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3794 PARK AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381116649",
            "telephone_number": "901-323-7970",
            "fax_number": "901-323-0061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGGETT",
        "first_name": "LARRY",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2019-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "TN",
            "license": "DPM285",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3351088",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.