Active NPI
Gina R. Hanissian, MD
- Internal Medicine Physician
- Collierville, TN
National Provider Identifier
1710053327
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 31681
- Practice address
- 574 Greentree Cove
Suite 101
Collierville, TN 38017 - Phone
- (901) 853-2021
- Fax
- (901) 853-2434
- NPI assigned
- Nov 27, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adolescent Medicine (Internal Medicine) Physician | 207RA0000X | 31681 | TN | |
| Internal Medicine Physician | 207R00000X | 31681 | TN | Primary |
| Pediatrics Physician | 208000000X | 31681 | TN |
Addresses
Primary practice location
574 Greentree Cove
Suite 101
Collierville, TN 38017
Mailing address
6799 Great Oaks Rd #250
Suite 250
Memphis, TN 38138
Phone (901) 261-0700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4036588 | Other | TN | BCBS PROVIDER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of Tennessee, HSC, College of Medicine, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
6799 Great Oaks Rd
Suite 250
Memphis, TN 38138-2584
Phone (901) 261-0700
Hospital & facility affiliations
- Amedisys Home Care
- Baptist Memorial Hospital
- Methodist Hospitals of Memphis
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31681 | TN | MD | Adolescent Medicine (Internal Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Consolidated Medical Practices of Memphis,PLLC | Internal Medicine | Current | Accepting new patients |
| Frederick Health Hospital Inc | Past | Accepting new patients | |
| Ara James Hanissian MD PLLC | Internal Medicine | Past | Accepting new patients |
Locations
574 Green Tree Cv
Ste 101
Collierville, TN 38017
Phone (901) 853-2021
6799 Great Oaks Rd
Ste 250
Memphis, TN 38138
Phone (901) 261-0700
Interoperability endpoints
- ghanissian26307@mlh.direct-ci.com
- https://fhir4.healow.com/fhir/r4/IBHBDD
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Internal Medicine Physician
- Memphis, TN
- NPI 1508027491
-
- Internal Medicine Physician
- Collierville, TN
- NPI 1588838411
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Memphis, TN
- NPI 1578527172
-
- Children's Hospital
- Memphis, TN
- NPI 1386709871
-
- General Acute Care Hospital
- Memphis, TN
- NPI 1558365890
-
- Children's Hospital
- Germantown, TN
- NPI 1649654450
-
- Home Health Agency
- Memphis, TN
- NPI 1629018999
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1264464000000",
"number": "1710053327",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6799 GREAT OAKS RD #250",
"address_2": "SUITE 250",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "38138",
"telephone_number": "901-261-0700",
"fax_number": "901-261-0701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "574 GREENTREE COVE",
"address_2": "SUITE 101",
"city": "COLLIERVILLE",
"state": "TN",
"postal_code": "38017",
"telephone_number": "901-853-2021",
"fax_number": "901-853-2434"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANISSIAN",
"first_name": "GINA",
"middle_name": "R.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-27",
"last_updated": "2010-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "207RA0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Adolescent Medicine",
"state": "TN",
"license": "31681",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "TN",
"license": "31681",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TN",
"license": "31681",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER",
"identifier": "4036588",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Collierville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.