Collierville Family Medicine PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

COLLIERVILLE FAMILY MEDICINE PC

Practice address

1500 W Poplar Ave
Suite 310
Collierville, TN 38017-0601

Phone

(901) 457-7060

Fax

(901) 457-7062

NPI assigned

Feb 18, 2010

Organization subpart

No

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

Authorized official

Name

Sowmya Brahmadevi, M.D.

Title

Owner

Phone

(901) 457-7060

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1266451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1385424000000",
    "number": "1669794574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 W POPLAR AVE",
            "address_2": "SUITE 310",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380170601",
            "telephone_number": "901-457-7060",
            "fax_number": "901-457-7062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 W POPLAR AVE",
            "address_2": "SUITE 310",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380170601",
            "telephone_number": "901-457-7060",
            "fax_number": "901-457-7062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLIERVILLE FAMILY MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-18",
        "last_updated": "2013-11-26",
        "status": "A",
        "authorized_official_last_name": "BRAHMADEVI",
        "authorized_official_first_name": "SOWMYA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "901-457-7060",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gary Dean Clouse, DPT
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• Collierville Healthcare Corp
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• Collierville Medical Specialists
• Collierville Nursing and Rehabilitation LLC
• Collierville Orthopedics and

• Family Medicine Physician in Collierville, TN
• Providers in Collierville, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2013; 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.