Individual provider Active NPI

Anthony Nicholas

  • Neurology Physician
  • Memphis, TN
National Provider Identifier
1588695928
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
74843 Issued in TN
Practice address
930 Madison Ave Ste 801
Memphis, TN 38103-3410
Phone
(901) 866-8805
NPI assigned
Jul 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 18697 AL
Neurology Physician 2084N0400X 74843 TN Primary

Addresses

Primary practice location

930 Madison Ave Ste 801
Memphis, TN 38103-3410

Mailing address

1068 Cresthaven Rd Ste 300
Memphis, TN 38119-0809

Other practice location 1

6555 Quince Rd
Memphis, TN 38119-8202
Phone (901) 515-3150

Other practice location 2

880 Madison Ave
Memphis, TN 38103-3409
Phone (901) 545-5946

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, 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

Enrollment IDStateProvider typePAC IDDetails
I20111101000367 AL Practitioner - Neurology 0345413688 Reassigns benefits to 1 organization
I20250721003801 TN Practitioner - Neurology 0345413688 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of Texas Medical Branch at Galveston, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ut Regional One Physicians IncGroup PAC ID 5698993418, 314 clinicians
Ut Medical Group IncGroup PAC ID 3173435369, 98 clinicians

Practice addresses (Care Compare)

880 Madison Ave
Memphis, TN 38103-3409
Phone (901) 545-6969

930 Madison Ave
Suite 801
Memphis, TN 38103-3410
Phone (901) 866-8790

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Regional One Physicians Inc Neurology CurrentSince Aug 1, 2025 Accepting new patients
Ut Medical Group, Inc. CurrentSince Jul 14, 2025 Accepting new patients
Ut Regional One Physicians Inc CurrentSince Aug 1, 2025 Accepting new patients
University of Alabama Health Services Foundation, PC. CurrentSince Nov 5, 1996 Accepting new patients
Ut Medical Group Inc Neurology CurrentSince Jul 14, 2025 Accepting new patients

Locations

720 20th St S
Birmingham, AL 35233
Phone (205) 934-4983

1717 6th Ave S
Birmingham, AL 35233
Phone (205) 934-3450

619 19th St S
Birmingham, AL 35233
Phone (205) 934-6405

619 19th St S
Birmingham, AL 35249

6555 Quince Rd
Memphis, TN 38119
Phone (901) 515-3150

6215 Humphreys Blvd
Ste 201
Memphis, TN 38120
Phone (901) 866-8085

930 Madison Ave
Ste 801
Memphis, TN 38103
Phone (901) 866-8605

1068 Cresthaven Rd
Ste 300
Memphis, TN 38119
Phone (901) 683-0024

930 Madison Ave
Ste 200
Memphis, TN 38103
Phone (901) 448-6650

880 Madison Ave
Memphis, TN 38103
Phone (901) 515-3500

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1588695928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1068 CRESTHAVEN RD STE 300",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381190809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 MADISON AVE STE 801",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381033410",
            "telephone_number": "901-866-8805"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6555 Quince Rd",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381198202",
            "country_code": "US",
            "telephone_number": "901-515-3150",
            "fax_number": "901-515-3179",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "880 Madison Ave",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381033409",
            "country_code": "US",
            "telephone_number": "901-545-5946",
            "fax_number": "901-515-4748",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLAS",
        "first_name": "ANTHONY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "AL",
            "license": "18697",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TN",
            "license": "74843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.