NPIMap

Organization Active NPI

Cardiovascular Surgery Clinic, PLLC

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Memphis, TN
National Provider Identifier
1649211418
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
17068 Issued in TN
Legal business name
CARDIOVASCULAR SURGERY CLINIC, PLLC
Practice address
6029 Walnut Grove Rd
Suite 401
Memphis, TN 38120-2112
Phone
(901) 747-3066
Fax
(901) 747-2966
NPI assigned
Jun 10, 2006
Reactivated
Apr 24, 2019
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Harvey Edward Garrett, M.D.NPI 1508800905
Title
President
Phone
(901) 747-3066

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 17068 TN Primary

Addresses

Primary practice location

6029 Walnut Grove Rd
Suite 401
Memphis, TN 38120-2112

Mailing address

6029 Walnut Grove Rd
Suite 401
Memphis, TN 38120-2112
Phone (901) 747-3066

Other identifiers 3

IdentifierTypeStateIssuer
8P057OtherARBCBS GRP #
09016196MedicaidMS
3713059MedicaidTN

National Provider Directory

National Provider Directory

Locations

7603 Southcrest Pkwy
Ste 302
Southaven, MS 38671
Phone (601) 349-0707

51 Germantown Ct
Ste 100
Cordova, TN 38018

6029 Walnut Grove Rd
Ste 401
Memphis, TN 38120
Phone (901) 226-0456

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1649211418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6029 WALNUT GROVE RD",
            "address_2": "SUITE 401",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202112",
            "telephone_number": "901-747-3066",
            "fax_number": "901-747-2966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6029 WALNUT GROVE RD",
            "address_2": "SUITE 401",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202112",
            "telephone_number": "901-747-3066",
            "fax_number": "901-747-2966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIOVASCULAR SURGERY CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-10",
        "last_updated": "2020-08-22",
        "deactivation_date": "2019-02-04",
        "reactivation_date": "2019-04-24",
        "status": "A",
        "authorized_official_last_name": "GARRETT",
        "authorized_official_first_name": "HARVEY",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "901-747-3066",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "TN",
            "license": "17068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GRP #",
            "identifier": "8P057",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09016196",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3713059",
            "state": "TN"
        }
    ],
    "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 Aug 22, 2020; 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.