NPIMap

Organization Active NPI

University of Tennessee

  • Oral and Maxillofacial Pathology Dentistry
  • Memphis, TN
National Provider Identifier
1487723094
Registry record updated Dec 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X
Legal business name
UNIVERSITY OF TENNESSEE
Practice address
875 Union Ave
Room C309
Memphis, TN 38163-0001
Phone
(901) 448-5876
Fax
(901) 448-6835
NPI assigned
Nov 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2020

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

Authorized official

Name
Anthony A Ferrara
Title
Sr Vice Chancellor Chief Financial
Phone
(901) 448-5523

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Pathology DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0106X Primary

Addresses

Primary practice location

875 Union Ave
Room C309
Memphis, TN 38163-0001

Mailing address

875 Union Ave
Room C309
Memphis, TN 38163-0001
Phone (901) 448-5876

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031119000671 TN Part B Supplier - Clinic/Group Practice 3072421213 Receives reassigned benefits from 54 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Memphis, TN; Jackson, TN

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Ut CT HLTH SC Fam Prac CT26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

Organizations that report the same tax identification number in the National Provider Directory.

View all 25

Locations

875 Union Ave
Memphis, TN 38103
Phone (901) 448-6210

875 Union Ave
Ste 309
Memphis, TN 38103

Practitioners & affiliated clinicians

Practitioners 7

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": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608249600000",
    "number": "1487723094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 UNION AVE",
            "address_2": "ROOM C309",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381630001",
            "telephone_number": "901-448-5876",
            "fax_number": "901-448-6835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 UNION AVE",
            "address_2": "ROOM C309",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381630001",
            "telephone_number": "901-448-5876",
            "fax_number": "901-448-6835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF TENNESSEE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A",
        "authorized_official_last_name": "FERRARA",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SR VICE CHANCELLOR CHIEF FINANCIAL",
        "authorized_official_telephone_number": "901-448-5523"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Dec 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.