Active NPI
Gregory Josef Condon, MD
- Neurology Physician
- Memphis, TN
National Provider Identifier
1477512291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 0000018003
- Practice address
- 1211 Union Ave
Suite 400
Memphis, TN 38104 - Phone
- (901) 725-8920
- Fax
- (901) 725-8934
- NPI assigned
- Mar 21, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 0000018003 | TN | Primary |
Addresses
Primary practice location
1211 Union Ave
Suite 400
Memphis, TN 38104
Mailing address
PO Box 1885
Memphis, TN 38101-1885
Phone (901) 725-8920
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3026721 | Medicaid | TN | |
| 158519001 | Medicaid | AR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0000018003 | TN | MD | Neurology Physician |
| 18003 | TN | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142899200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1360627200000",
"number": "1477512291",
"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": "901-725-8934"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1211 UNION AVE",
"address_2": "SUITE 400",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "38104",
"telephone_number": "901-725-8920",
"fax_number": "901-725-8934"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONDON",
"first_name": "GREGORY",
"middle_name": "JOSEF",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-21",
"last_updated": "2013-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "TN",
"license": "0000018003",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3026721",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "158519001",
"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 Feb 12, 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.