NPIMap

Organization Active NPI

Medical Anesthesia Group, PA

  • Anesthesiology Physician
  • Memphis, TN
National Provider Identifier
1679527501
Registry record updated Oct 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
MEDICAL ANESTHESIA GROUP, PA
Practice address
6060 Primacy Pkwy Ste 241
Memphis, TN 38119
Phone
(901) 725-5846
Fax
(901) 726-4827
NPI assigned
May 22, 2006
Last updated
Oct 17, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2026

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

Authorized official

Name
Matthew Johnson
Title
Practice Administrator
Phone
(901) 725-5846

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X NU Primary

Addresses

Primary practice location

6060 Primacy Pkwy Ste 241
Memphis, TN 38119

Mailing address

PO Box 11407 Dept 2607
Birmingham, AL 35246-2607
Phone (901) 725-5846

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://cpiapigateway.cms.gov/api/esmdf/ext/v1/fhir/Practitioner/ Other Management Services Network, LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, AR, MS4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
O20040309000411 TN Part B Supplier - Clinic/Group Practice 9436047685 Receives reassigned benefits from 74 practitioners
Practice locations: Memphis, TN
O20040726000882 TN Part B Supplier - Clinic/Group Practice 9436047685 Receives reassigned benefits from 100 practitioners
Practice locations: Memphis, TN; Germantown, TN
O20130611000373 AR Part B Supplier - Clinic/Group Practice 9436047685 Receives reassigned benefits from 14 practitioners
Practice locations: Marion, AR
O20130911000704 MS Part B Supplier - Clinic/Group Practice 9436047685 Receives reassigned benefits from 82 practitioners
Practice locations: Olive Branch, MS; Southaven, MS

National Provider Directory

National Provider Directory

Locations

7668 Airways Blvd
Ste 100
Southaven, MS 38671
Phone (662) 349-6950

1325 Wolf Park Dr
Memphis, TN 38138
Phone (901) 252-3400

1417 Monroe Ave
Memphis, TN 38104
Phone (901) 272-7200

1755 Kirby Pkwy
Ste 330
Memphis, TN 38120
Phone (901) 725-5846

5999 Park Ave
Memphis, TN 38119
Phone (901) 818-1080

6060 E Primacy Pkwy
Ste 241
Memphis, TN 38119
Phone (901) 725-5846

Practitioners & affiliated clinicians

Practitioners 252

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.

View all 252

NPI Registry JSON

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1792195200000",
    "number": "1679527501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11407 DEPT 2607",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352462607",
            "telephone_number": "901-725-5846",
            "fax_number": "901-726-4827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6060 PRIMACY PKWY STE 241",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38119",
            "telephone_number": "901-725-5846",
            "fax_number": "901-726-4827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL ANESTHESIA GROUP, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-22",
        "last_updated": "2026-10-17",
        "certification_date": "2026-10-17",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "901-725-5846"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://cpiapigateway.cms.gov/api/esmdf/ext/v1/fhir/Practitioner/",
            "affiliation": "Y",
            "endpointDescription": "urn:oid:2.16.840.1.113883.3.1036.1",
            "affiliationName": "Management Services Network, LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2357 Warm Springs Rd Ste 400",
            "city": "Columbus",
            "state": "GA",
            "country_code": "US",
            "postal_code": "319046874",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Oct 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.