NPIMap

Organization Active NPI

North Internal Medicine, P. C.

  • Internal Medicine Physician
  • Memphis, TN
National Provider Identifier
1518982008
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
NORTH INTERNAL MEDICINE, P. C.
Practice address
4901 Raleigh Commons Drive
Suite 200
Memphis, TN 38128
Phone
(901) 387-0193
Fax
(901) 387-0796
NPI assigned
Jul 13, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dudley Kelso
Title
Office Manager
Phone
(901) 387-0193

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

4901 Raleigh Commons Drive
Suite 200
Memphis, TN 38128

Mailing address

PO Box 216
Memphis, TN 38101-0216
Phone (901) 387-0193

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040116000448 TN Part B Supplier - Clinic/Group Practice 1355242959 Receives reassigned benefits from 5 practitioners
Practice locations: Bartlett, TN

National Provider Directory

National Provider Directory

Locations

7378 Yale Rd
Bartlett, TN 38133
Phone (901) 387-0193

Practitioners & affiliated clinicians

Practitioners 62

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 62

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1518982008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 216",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381010216",
            "telephone_number": "901-387-0193",
            "fax_number": "901-387-0193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 RALEIGH COMMONS DRIVE",
            "address_2": "SUITE 200",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38128",
            "telephone_number": "901-387-0193",
            "fax_number": "901-387-0796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH INTERNAL MEDICINE, P. C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KELSO",
        "authorized_official_first_name": "DUDLEY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "901-387-0193"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "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 Aug 22, 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.