NPIMap

Organization Active NPI

Memphis Neurology PLLC

  • Neurology Physician
  • Germantown, TN
National Provider Identifier
1700943172
Registry record updated Jan 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
MEMPHIS NEUROLOGY PLLC
Practice address
7645 Wolf River Cir
Germantown, TN 38138-1751
Phone
(901) 405-0275
Fax
(901) 405-0288
NPI assigned
Jan 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2014

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

Authorized official

Name
Loretta Brown
Title
Office Administrator
Phone
(901) 405-0275

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental - Behavioral Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080P0006X
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X Primary
Neurology with Special Qualifications in Child Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0402X
Clinical Neurophysiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0600X
Neurodevelopmental Disabilities PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0005X

Addresses

Primary practice location

7645 Wolf River Cir
Germantown, TN 38138-1751

Mailing address

7645 Wolf River Cir Ste 100
Germantown, TN 38138-1751
Phone (901) 405-0275

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080423000614 MS Part B Supplier - Clinic/Group Practice 2264510718 Receives reassigned benefits from 8 practitioners
Practice locations: Southaven, MS
O20080429000637 TN Part B Supplier - Clinic/Group Practice 2264510718 Receives reassigned benefits from 16 practitioners
Practice locations: Germantown, TN

National Provider Directory

National Provider Directory

Locations

830 S Gloster St
#4
Tupelo, MS 38801

4501 Mueller Brass Rd
Covington, TN 38019
Phone (901) 476-7779

7645 Wolf River Cir
Memphis, TN 38138
Phone (901) 405-0275

777 Washington Ave
Ste 230
Memphis, TN 38105
Phone (901) 405-0275

1407 Union Ave
Ste 1400
Memphis, TN 38104
Phone (901) 405-0275

777 Washington Ave
Ste P320
Memphis, TN 38105
Phone (901) 869-2905

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.73850

Practitioners & affiliated clinicians

Practitioners 33

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

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390867200000",
    "number": "1700943172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7645 WOLF RIVER CIR STE 100",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381381751",
            "telephone_number": "901-405-0275",
            "fax_number": "901-405-0288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7645 WOLF RIVER CIR",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381381751",
            "telephone_number": "901-405-0275",
            "fax_number": "901-405-0288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMPHIS NEUROLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2014-01-28",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "LORETTA",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "901-405-0275"
    },
    "taxonomies": [
        {
            "code": "2080P0006X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurodevelopmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2014; 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.