NPIMap

Organization Active NPI

Payne Family Dentistry

  • General Practice Dentistry
  • Memphis, TN
National Provider Identifier
1699062273
Registry record updated Jul 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7038 Issued in TN
Legal business name
PAYNE FAMILY DENTISTRY
Practice address
3574 Hickory Hill Rd
Memphis, TN 38115-3827
Phone
(901) 365-9054
NPI assigned
Jul 5, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2011

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

Authorized official

Name
Dr. Adrienne M Jackson-Payne, D.D.SNPI 1992884845
Title
Dentist/Owner
Phone
(901) 365-9054

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 5420 MO
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 7038 TN Primary

Addresses

Primary practice location

3574 Hickory Hill Rd
Memphis, TN 38115-3827

Mailing address

3574 Hickory Hill Rd
Memphis, TN 38115-3827
Phone (901) 365-9054

Other identifiers 2

IdentifierTypeStateIssuer
1881777670MedicaidTN
1992884845MedicaidTN

National Provider Directory

National Provider Directory

Locations

3574 Hickory Hill Rd
Memphis, TN 38115
Phone (901) 365-9054

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1309824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309824000000",
    "number": "1699062273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3574 HICKORY HILL RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381153827",
            "telephone_number": "901-365-9054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3574 HICKORY HILL RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381153827",
            "telephone_number": "901-365-9054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAYNE FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-05",
        "last_updated": "2011-07-05",
        "status": "A",
        "authorized_official_last_name": "JACKSON-PAYNE",
        "authorized_official_first_name": "ADRIENNE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "901-365-9054",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MO",
            "license": "5420",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "7038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1881777670",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1992884845",
            "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 Jul 5, 2011; 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.