Individual provider Active NPI

Kaushal Kalra, MD

  • Family Medicine Physician
  • Memphis, TN
National Provider Identifier
1467896506
Registry record updated Jun 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
60782 Issued in TN
Practice address
1325 Eastmoreland Ave Ste 150
Memphis, TN 38104-3555
Phone
(901) 516-9830
Fax
(901) 516-9837
NPI assigned
Apr 19, 2013
Last updated
Jun 24, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 60782 TN Primary
Family Medicine Physician 207Q00000X 4301102329 MI

Addresses

Primary practice location

1325 Eastmoreland Ave Ste 150
Memphis, TN 38104-3555

Mailing address

PO Box 1000, Dept 978
Memphis, TN 38148-0001
Phone (901) 758-9900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200624003289 TN Practitioner - Family Practice 9234363300 Reassigns benefits to 1 organization
I20240828002627 TN Practitioner - Single Or Multispecialty Clinic Or Group Practice 9234363300 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Primary Care Group, LLCGroup PAC ID 0941480131, 108 clinicians

Practice addresses (Care Compare)

1325 Eastmoreland Ave
Suite 150
Memphis, TN 38104-3555
Phone (901) 516-9830

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
60782TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care Group LLC Family Medicine CurrentSince Jun 13, 2020 Accepting new patients
Health 360 PLLC Family Medicine CurrentSince Jul 17, 2024 Accepting new patients

Locations

2961 Canada Rd
Ste 105
Lakeland, TN 38002
Phone (901) 388-0115

1211 Union Ave
Ste 330
Memphis, TN 38104
Phone (901) 478-0954

1325 Eastmoreland Ave
Ste 150
Memphis, TN 38104
Phone (901) 516-9830

1717 Kirby Pkwy
Memphis, TN 38120
Phone (901) 272-7200

Interoperability endpoints

  • Direct secure messaging: kkalra28602@mlh.direct-ci.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1366329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592956800000",
    "number": "1467896506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1000, DEPT 978",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381480001",
            "telephone_number": "901-758-9900",
            "fax_number": "901-752-2335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 EASTMORELAND AVE STE 150",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381043555",
            "telephone_number": "901-516-9830",
            "fax_number": "901-516-9837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALRA",
        "first_name": "KAUSHAL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-19",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "60782",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301102329",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.