Active NPI
Bruce Leonard Webber, MD
- Anatomic Pathology Physician
- Memphis, TN
National Provider Identifier
1598795494
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology Physician
- License
- MD0000012393
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000005210 | Medicaid | TN | |
| 3025108 | Other | TN | BLUE CROSS BLUE SHIELD |
| 3025108 | Medicaid | TN | |
| 3041868 | Medicaid | TN | |
| 96813 | Other | AR | BLUE 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
| License | State | Type | Specialty |
|---|---|---|---|
| 12393 | TN | MD | Pharmacist |
| MD0000012393 | TN | MD | Anatomic 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.