Individual provider Active NPI

Bruce Leonard Webber, MD

  • Anatomic Pathology Physician
  • Memphis, TN
National Provider Identifier
1598795494
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology PhysicianTaxonomy code 207ZP0101X
License
MD0000012393 Issued in TN
Practice address
6046 Knight Arnold Road Ext
Suite 101
Memphis, TN 38115-3347
Phone
(901) 542-6801
Fax
(901) 542-6871
NPI assigned
Jul 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology Physician 207ZP0101X MD0000012393 TN Primary

Addresses

Primary practice location

6046 Knight Arnold Road Ext
Suite 101
Memphis, TN 38115-3347

Mailing address

6046 Knight Arnold Road Ext
Suite 101
Memphis, TN 38115-3347
Phone (901) 542-6801

Other identifiers 5

IdentifierTypeStateIssuer
000000005210MedicaidTN
3025108OtherTNBLUE CROSS BLUE SHIELD
3025108MedicaidTN
3041868MedicaidTN
96813OtherARBLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
12393TNMDPharmacist
MD0000012393TNMDAnatomic Pathology Physician

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1598795494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6046 KNIGHT ARNOLD ROAD EXT",
            "address_2": "SUITE 101",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381153347",
            "telephone_number": "901-542-6801",
            "fax_number": "901-542-6871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6046 KNIGHT ARNOLD ROAD EXT",
            "address_2": "SUITE 101",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381153347",
            "telephone_number": "901-542-6801",
            "fax_number": "901-542-6871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBBER",
        "first_name": "BRUCE",
        "middle_name": "LEONARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "TN",
            "license": "MD0000012393",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000000005210",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "3025108",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3025108",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3041868",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "96813",
            "state": "AR"
        }
    ],
    "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 Jul 9, 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.