NPIMap

Organization Active NPI

Private Senior Providers Etp LLC

  • Health Maintenance Organization
  • Memphis, TN
National Provider Identifier
1568564425
Registry record updated Aug 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
Legal business name
PRIVATE SENIOR PROVIDERS ETP LLC
Practice address
234 Pandora St
Co/Brenda Thompson
Memphis, TN 38117-2855
Phone
(901) 315-8619
Fax
(901) 763-2907
NPI assigned
Sep 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2007

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

Authorized official

Name
Mrs. Nancy Sherman Gillespie, HOME HEALTH AIDE
Title
Owner
Phone
(901) 315-8619

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X Primary

Addresses

Primary practice location

234 Pandora St
Co/Brenda Thompson
Memphis, TN 38117-2855

Mailing address

PO Box 770193
Memphis, TN 38177-0193
Phone (901) 315-8619

National Provider Directory

National Provider Directory
Tax ID family
Angelwings Healthcare2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185926400000",
    "number": "1568564425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 770193",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381770193",
            "telephone_number": "901-315-8619",
            "fax_number": "901-761-2907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 PANDORA ST",
            "address_2": "CO/BRENDA THOMPSON",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381172855",
            "telephone_number": "901-315-8619",
            "fax_number": "901-763-2907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIVATE SENIOR PROVIDERS ETP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-02",
        "last_updated": "2007-08-01",
        "status": "A",
        "authorized_official_last_name": "GILLESPIE",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "SHERMAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "901-315-8619",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "HOME HEALTH AIDE"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": null,
            "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 1, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.