NPIMap

Individual provider Active NPI

Corey Shane McGlothan, M.D.

  • Obstetrics Physician
  • Memphis, TN
National Provider Identifier
1609985522
Registry record updated Dec 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics PhysicianTaxonomy code 207VX0000X
License
207VX0000X Issued in TN
Practice address
1264 Wesley Dr
Ste 402
Memphis, TN 38116-6400
Phone
(901) 396-5577
Fax
(901) 396-5585
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics Physician 207VX0000X 207VX0000X TN Primary

Addresses

Primary practice location

1264 Wesley Dr
Ste 402
Memphis, TN 38116-6400

Mailing address

1264 Wesley Dr
Ste 402
Memphis, TN 38116-6400
Phone (901) 396-5577

Other identifiers 1

IdentifierTypeStateIssuer
3886979MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040602001357 TN Practitioner - Obstetrics/Gynecology 2264414333 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Alabama School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Tennessee Medical Group IncGroup PAC ID 3971781006, 190 clinicians
WT Medical AssociatesGroup PAC ID 1951650613, shared by 5 NPIs, 64 clinicians

Practice addresses (Care Compare)

1264 Wesley Dr
Suite 402
Memphis, TN 38116-6447
Phone 9013965577124

1720 Woodlawn Ave
Dyersburg, TN 38024-1300
Phone (731) 421-6510

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
207VX0000XTNMDObstetrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memphis Health Center, Inc. CurrentSince Dec 13, 2023 Accepting new patients
Memphis Health Center, Inc. CurrentSince Dec 13, 2023 Accepting new patients
Methodist Healthcare - Memphis Hospitals Past Accepting new patients
Baptist Memorial Hospital Past Accepting new patients
Dyersburg Health Past Accepting new patients

Locations

360 E Eh Crump Blvd
Memphis, TN 38126
Phone (901) 261-2000

4940 Highway 57
Ste 107
Rossville, TN 38066
Phone (901) 261-2221

Interoperability endpoints

  • Direct secure messaging: cmcglothan24375@mlh.direct-ci.com

Organizations & group practices 7

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 3

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292803200000",
    "number": "1609985522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1264 WESLEY DR",
            "address_2": "STE 402",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381166400",
            "telephone_number": "901-396-5577",
            "fax_number": "901-396-5585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1264 WESLEY DR",
            "address_2": "STE 402",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381166400",
            "telephone_number": "901-396-5577",
            "fax_number": "901-396-5585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGLOTHAN",
        "first_name": "COREY",
        "middle_name": "SHANE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2010-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "TN",
            "license": "207VX0000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3886979",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.