NPIMap

Organization Active NPI

Levy Dermatology, PC

  • Dermatology Physician
  • Germantown, TN
National Provider Identifier
1508007790
Registry record updated Jan 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD0000043501 Issued in TN
Legal business name
LEVY DERMATOLOGY, PC
Practice address
1920 Kirby Pkwy Ste 204
Germantown, TN 38138-3697
Phone
(901) 624-3333
Fax
(901) 624-1203
NPI assigned
Mar 17, 2009
Last updated
Jan 16, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2013

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

Authorized official

Name
Dr. Alan Louis Levy, M.D.NPI 1497978340
Title
President/Ceo
Phone
(901) 682-0430

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X MD0000043501 TN Primary
MOHS-Micrographic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ND0101X MD0000043501 TN
Procedural Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207NS0135X MD0000043501 TN

Addresses

Primary practice location

1920 Kirby Pkwy Ste 204
Germantown, TN 38138-3697

Mailing address

1920 Kirby Pkwy Ste 204
Germantown, TN 38138-3697
Phone (901) 624-3333

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090818000680 TN Part B Supplier - Clinic/Group Practice 9032263538 Receives reassigned benefits from 18 practitioners
Practice locations: Memphis, TN

National Provider Directory

National Provider Directory

Locations

1125 Schilling Blvd E
Collierville, TN 38017
Phone (901) 248-7440

158 Murray Guard Dr
Jackson, TN 38305

6254 Poplar Ave
Memphis, TN 38119
Phone (901) 624-3333

Practitioners & affiliated clinicians

Practitioners 21

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 21

NPI Registry JSON

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

{
    "created_epoch": "1237248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358294400000",
    "number": "1508007790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 KIRBY PKWY STE 204",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381383697",
            "telephone_number": "901-624-3333",
            "fax_number": "901-624-1203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 KIRBY PKWY STE 204",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381383697",
            "telephone_number": "901-624-3333",
            "fax_number": "901-624-1203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEVY DERMATOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-17",
        "last_updated": "2013-01-16",
        "status": "A",
        "authorized_official_last_name": "LEVY",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "LOUIS",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "901-682-0430",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "TN",
            "license": "MD0000043501",
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "TN",
            "license": "MD0000043501",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "TN",
            "license": "MD0000043501",
            "primary": false
        }
    ],
    "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 16, 2013; 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.