NPIMap

Organization Active NPI

Memphis & Shelby County Ped. Group

  • Pediatrics Physician
  • Memphis, TN
National Provider Identifier
1710067020
Registry record updated Mar 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
MEMPHIS & SHELBY COUNTY PED. GROUP
Practice address
1444 E Shelby Dr
Suite 317
Memphis, TN 38116-7260
Phone
(901) 396-8281
NPI assigned
Oct 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2014

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

Authorized official

Name
Mrs. Katherine Carter
Title
Billing Supervisor
Phone
(901) 396-8366

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

1444 E Shelby Dr
Suite 317
Memphis, TN 38116-7260

Mailing address

1444 E Shelby Dr
Suite 317
Memphis, TN 38116-7260
Phone (901) 396-8281

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D0314283Memphis and Shelby County Pediatric Group1444 East Shelby Drive Suite 317, Memphis, TN 38116ComplianceJan 24, 2027

National Provider Directory

National Provider Directory
Tax ID family
Memphis Shelby County Ped Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

6479 Winchester Rd
Ste 118
Memphis, TN 38115
Phone (901) 866-2133

1444 E Shelby Dr
Ste 317
Memphis, TN 38116
Phone (901) 396-8281

1444 E Shelby Dr
Ste 330
Memphis, TN 38116

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395100800000",
    "number": "1710067020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1444 E SHELBY DR",
            "address_2": "SUITE 317",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381167260",
            "telephone_number": "901-396-8281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1444 E SHELBY DR",
            "address_2": "SUITE 317",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381167260",
            "telephone_number": "901-396-8281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMPHIS & SHELBY COUNTY PED. GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2014-03-18",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_title_or_position": "BILLING SUPERVISOR",
        "authorized_official_telephone_number": "901-396-8366",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Mar 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.

Verify at the official NPI Registry.