Individual provider Active NPI

John Witherington, MD

  • Internal Medicine Physician
  • Memphis, TN
National Provider Identifier
1720008709
Registry record updated Jul 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD141835 Issued in TN
Practice address
6570 Heronswood Dr
Memphis, TN 38119-6646
Phone
(901) 842-1473
Fax
(901) 844-1439
NPI assigned
Jul 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD0000014835 TN
Internal Medicine Physician 207R00000X MD141835 TN Primary

Addresses

Primary practice location

6570 Heronswood Dr
Memphis, TN 38119-6646

Mailing address

PO Box 17476
Memphis, TN 38187-0476
Phone (901) 842-1473

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040614001166 TN Practitioner - Internal MedicinePractitioner - Emergency Medicine 4587648001 Practice locations: Memphis, TN; Germantown, TN

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD0000014835TNMDEmergency Medicine Physician
MD141835TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tennessee Em-I Medical Services, PC Emergency Medicine Past Accepting new patients
Cane Ridge Emergency Physicians LLC Emergency Medicine Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374537600000",
    "number": "1720008709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17476",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381870476",
            "telephone_number": "901-842-1473",
            "fax_number": "901-844-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6570 HERONSWOOD DR",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381196646",
            "telephone_number": "901-842-1473",
            "fax_number": "901-844-1439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITHERINGTON",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2013-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "MD0000014835",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD141835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.