Individual provider Active NPI

Anum Abbas, PA

  • Physician Assistant
  • Memphis, TN
National Provider Identifier
1548048671
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5683 Issued in TN
Practice address
1211 Union Ave Ste 495
Memphis, TN 38104-6656
Phone
(901) 507-6600
NPI assigned
Sep 19, 2023
Last updated
Oct 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5683 TN Primary

Addresses

Primary practice location

1211 Union Ave Ste 495
Memphis, TN 38104-6656

Mailing address

748 Rain Dance Way
Cordova, TN 38018-1479

Other practice location 1

748 Rain Dance Way
Cordova, TN 38018-1479
Phone (662) 801-5446

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240612001614 TN Practitioner - Physician Assistant 9436691912 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Lincoln Memorial University Medical Department, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Heart Center of Memphis PLLCGroup PAC ID 2961492749, 2 clinicians

Practice addresses (Care Compare)

1211 Union Ave
Suite 495
Memphis, TN 38104-6656
Phone (901) 507-6600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-South Cardiovascular Center, LLC PastSince Oct 27, 2024 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1695081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1548048671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "748 RAIN DANCE WAY",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380181479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 UNION AVE STE 495",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381046656",
            "telephone_number": "901-507-6600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "748 Rain Dance Way",
            "address_purpose": "LOCATION",
            "city": "Cordova",
            "state": "TN",
            "postal_code": "380181479",
            "country_code": "US",
            "telephone_number": "662-801-5446",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABBAS",
        "first_name": "ANUM",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-19",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "5683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.