Organization Active NPI

Phoenix Neurosurgery, PLLC

  • Neurological Surgery Physician
  • Memphis, TN
National Provider Identifier
1740470863
Registry record updated Jul 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
PHOENIX NEUROSURGERY, PLLC
Practice address
5673 S Rex Rd
Memphis, TN 38119-3821
Phone
(901) 276-6400
Fax
(901) 276-6440
NPI assigned
Jul 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2007

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

Authorized official

Name
Ms. Denise Renee Purifoy
Title
Office Manager
Phone
(901) 276-6453

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207T00000X Primary

Addresses

Primary practice location

5673 S Rex Rd
Memphis, TN 38119-3821

Mailing address

5673 S Rex Rd
Memphis, TN 38119-3821
Phone (901) 276-6400

Other identifiers 1

IdentifierTypeStateIssuer
3075466OtherTNMEDICARE ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081115000191 TN Part B Supplier - Clinic/Group Practice 3173503083 Receives reassigned benefits from 1 practitioner
Practice locations: Memphis, TN

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
44D2003216Phoenix Neurosurgery PLLC5673 S Rex Road, Memphis, TN 38119Certificate of waiverFeb 3, 2028

National Provider Directory

National Provider Directory

Locations

5673 S Rex Rd
Memphis, TN 38119
Phone (901) 276-6400

Practitioners & affiliated clinicians

Practitioners 5

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": "1185321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185321600000",
    "number": "1740470863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5673 S REX RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381193821",
            "telephone_number": "901-276-6400",
            "fax_number": "901-276-6440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5673 S REX RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381193821",
            "telephone_number": "901-276-6400",
            "fax_number": "901-276-6440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX NEUROSURGERY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-25",
        "last_updated": "2007-07-25",
        "status": "A",
        "authorized_official_last_name": "PURIFOY",
        "authorized_official_first_name": "DENISE",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "901-276-6453",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "3075466",
            "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 25, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.