Organization Active NPI

Mid-South Internal Medicine Specialists, P.C.

  • Internal Medicine Physician
  • Germantown, TN
National Provider Identifier
1467532754
Registry record updated Sep 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MID-SOUTH INTERNAL MEDICINE SPECIALISTS, P.C.
Practice address
7550 Wolf River Blvd
Suite 102
Germantown, TN 38138-1780
Phone
(901) 767-5000
Fax
(901) 767-6000
NPI assigned
Oct 17, 2006
Last updated
Sep 1, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2010

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

Authorized official

Name
Ms. Laura Kim Johns
Title
Office Manager
Phone
(901) 767-5000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

7550 Wolf River Blvd
Suite 102
Germantown, TN 38138-1780

Mailing address

7550 Wolf River Blvd
Suite 102
Germantown, TN 38138-1780
Phone (901) 767-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100524000342 TN Part B Supplier - Clinic/Group Practice 4486783883 Receives reassigned benefits from 15 practitioners
Practice locations: Germantown, TN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D0670151Mid-South Internal Medicine Specialist PC7550 Wolf River Blvd Suite 102, Germantown, TN 38138ComplianceNov 2, 2026

National Provider Directory

National Provider Directory

Locations

7550 Wolf River Blvd
Ste 102
Germantown, TN 38138
Phone (901) 767-5000

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283299200000",
    "number": "1467532754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7550 WOLF RIVER BLVD",
            "address_2": "SUITE 102",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381381780",
            "telephone_number": "901-767-5000",
            "fax_number": "901-767-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7550 WOLF RIVER BLVD",
            "address_2": "SUITE 102",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381381780",
            "telephone_number": "901-767-5000",
            "fax_number": "901-767-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-SOUTH INTERNAL MEDICINE SPECIALISTS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2010-09-01",
        "status": "A",
        "authorized_official_last_name": "JOHNS",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "KIM",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "901-767-5000",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.