Tanjala Trinette Gipson, MD

Primary specialty

Pediatric Neurodevelopmental Disabilities PhysicianTaxonomy code 2080P0008X

License

54122 Issued in TN

Practice address

51 N Dunlap St Ste 400
Memphis, TN 38105-4625

Phone

(901) 287-7337

Fax

(901) 387-5143

NPI assigned

Jan 25, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MD, TN2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tgipson34046@mlh.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• University of Tennessee

  • Developmental Disabilities Clinic/Center
  • Memphis, TN
  • NPI 1427064880
  Medicare reassignment NPD
• Ut Lebonheur Pediatric Specialists, Inc.

  • Pediatrics Physician
  • Memphis, TN
  • NPI 1093024101

  Neurodevelopmental Disabilities

  Medicare reassignment NPD
• Kennedy Krieger Associates

  • Pediatrics Physician
  • Baltimore, MD
  • NPI 1871515783
  Medicare reassignment NPD
• North Star Institute for Autism and Related Conditions

  • Pediatric Neurodevelopmental Disabilities Physician
  • Cordova, TN
  • NPI 1134749526
  NPD Authorized official
• University of Tennessee

  • Family Nurse Practitioner
  • Memphis, TN
  • NPI 1174221337
  NPD
• Kennedy Krieger Associates

  • Pediatrics Physician
  • Middle River, MD
  • NPI 1841009842
  NPD
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523664000000",
    "number": "1528113602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 POPLAR AVE BLDG 2",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381054607",
            "telephone_number": "901-287-5674",
            "fax_number": "901-287-6804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 N DUNLAP ST STE 400",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381054625",
            "telephone_number": "901-287-7337",
            "fax_number": "901-387-5143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIPSON",
        "first_name": "TANJALA",
        "middle_name": "TRINETTE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2018-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0008X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neurodevelopmental Disabilities",
            "state": "TN",
            "license": "54122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brooklyn Cody Giovannetti, RD, LDN
• Gipson Specialty Center, PLLC
• Jayme R Gipson, D.C.
• Michelle Denise Gipson
• Stephen Lavon Gipson, MD
• Tanya Glass Gipson, RN
• Giri Swamy MD PC
• Ojashwi Giri, PHARMD
• Katelyn Renee Girtain Haywood
• Travis M Gist

• Pediatric Neurodevelopmental Disabilities Physician in Memphis, TN
• Providers in Memphis, TN by specialty
• Pediatric Neurodevelopmental Disabilities Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.