NPIMap

Organization Active NPI

Germantown Private Psychiatry PLLC

  • Child & Adolescent Psychiatry Physician
  • Germantown, TN
National Provider Identifier
1467799767
Registry record updated Jan 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
MD0000045393 Issued in TN
Legal business name
GERMANTOWN PRIVATE PSYCHIATRY PLLC
Practice address
7505 Capital Dr
The Corporate Center
Germantown, TN 38138-3848
Phone
(901) 730-0575
Fax
(901) 730-0389
NPI assigned
Jan 8, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2013

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

Authorized official

Name
Arif Mirza, MDNPI 1669591012
Title
Owner
Phone
(901) 730-0575

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0804X MD0000045393 TN Primary

Addresses

Primary practice location

7505 Capital Dr
The Corporate Center
Germantown, TN 38138-3848

Mailing address

7505 Capital Dr
The Corporate Center
Germantown, TN 38138-3848
Phone (901) 730-0575

National Provider Directory

National Provider Directory

Locations

7505 Capital Dr
Germantown, TN 38138
Phone (901) 730-0575

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/6144/brand/1/csg/1/fhir/r4

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": "1357603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357603200000",
    "number": "1467799767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7505 CAPITAL DR",
            "address_2": "THE CORPORATE CENTER",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381383848",
            "telephone_number": "901-730-0575",
            "fax_number": "901-730-0389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7505 CAPITAL DR",
            "address_2": "THE CORPORATE CENTER",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381383848",
            "telephone_number": "901-730-0575",
            "fax_number": "901-730-0389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERMANTOWN PRIVATE PSYCHIATRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-08",
        "last_updated": "2013-01-08",
        "status": "A",
        "authorized_official_last_name": "MIRZA",
        "authorized_official_first_name": "ARIF",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "901-730-0575",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "TN",
            "license": "MD0000045393",
            "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 Jan 8, 2013; 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.