Immunobridge Medical Group, PLC

Primary specialty

Oncology Clinic/CenterTaxonomy code 261QX0200X

Legal business name

IMMUNOBRIDGE MEDICAL GROUP, PLC

Practice address

6055 Primacy Pkwy Ste 100
Memphis, TN 38119-5514

Phone

(901) 299-3129

NPI assigned

Aug 26, 2024

Organization subpart

No

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

Authorized official

Name

Dr. William H West, MDNPI 1063744035

Title

Ceo

Phone

(901) 299-3129

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Practitioners 1

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

• William Hoath West, M.D.

  • Medical Oncology Physician
  • Memphis, TN
  • NPI 1063744035
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1724630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724630400000",
    "number": "1588497366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6055 PRIMACY PKWY STE 100",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381195514",
            "telephone_number": "901-299-3129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6055 PRIMACY PKWY STE 100",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381195514",
            "telephone_number": "901-299-3129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMMUNOBRIDGE MEDICAL GROUP, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-26",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A",
        "authorized_official_last_name": "WEST",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "901-299-3129",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QX0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oncology Clinic/Center in Memphis, TN
• Providers in Memphis, TN by specialty
• Oncology Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; 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.