NPIMap

Organization Active NPI

Vogelfanger and Struble Clinic

  • Psychiatry Physician
  • Memphis, TN
National Provider Identifier
1508895764
Registry record updated Jul 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
VOGELFANGER AND STRUBLE CLINIC
Practice address
6005 Park Ave
Suite 630B
Memphis, TN 38119-5202
Phone
(901) 767-1136
Fax
(901) 767-0476
NPI assigned
Jul 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2013

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

Authorized official

Name
Sue Stovall, R.N.NPI 1033581764
Title
Office Manager
Phone
(901) 767-1136

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X TN
Psychiatry PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2084P0800X TN Primary
Child & Adolescent Psychiatry PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2084P0804X TN
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LP0808X TN

Addresses

Primary practice location

6005 Park Ave
Suite 630B
Memphis, TN 38119-5202

Mailing address

6005 Park Ave
Suite 630B
Memphis, TN 38119-5202
Phone (901) 767-1136

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20071102000168 TN Part B Supplier - Clinic/Group Practice 6608963954 Receives reassigned benefits from 15 practitioners
Practice locations: Memphis, TN
O20081111000630 MS Part B Supplier - Clinic/Group Practice 6608963954 Receives reassigned benefits from 1 practitioner
Practice locations: Olive Branch, MS

National Provider Directory

National Provider Directory

Locations

49 Old Hickory Blvd E
Jackson, TN 38305
Phone (731) 668-7073

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375228800000",
    "number": "1508895764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6005 PARK AVE",
            "address_2": "SUITE 630B",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381195202",
            "telephone_number": "901-767-1136",
            "fax_number": "901-767-0476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6005 PARK AVE",
            "address_2": "SUITE 630B",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381195202",
            "telephone_number": "901-767-1136",
            "fax_number": "901-767-0476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VOGELFANGER AND STRUBLE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-01",
        "last_updated": "2013-07-31",
        "status": "A",
        "authorized_official_last_name": "STOVALL",
        "authorized_official_first_name": "SUE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "901-767-1136",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TN",
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "TN",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": null,
            "primary": false
        }
    ],
    "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 Jul 31, 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.