Organization Active NPI

Laurelwood Pediatrics LLC

  • Pediatrics Physician
  • Memphis, TN
National Provider Identifier
1750416319
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
LAURELWOOD PEDIATRICS LLC
Practice address
5050 Sanderlin Ave
Memphis, TN 38117-4332
Phone
(901) 507-6907
Fax
(901) 761-1979
NPI assigned
Feb 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Violet V Williamson, ADMINISTRATOR
Title
Administrator
Phone
(901) 507-6907

Specialties & licenses 1

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

Addresses

Primary practice location

5050 Sanderlin Ave
Memphis, TN 38117-4332

Mailing address

5050 Sanderlin Ave
Memphis, TN 38117-4332
Phone (901) 507-6907

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
44D0898790Laurelwood Pediatrics, LLC5050 Sanderlin, Memphis, TN 38117Certificate of waiverAug 6, 2027

National Provider Directory

National Provider Directory

Locations

5050 Sanderlin Ave
Memphis, TN 38117
Phone (901) 683-9371

Practitioners & affiliated clinicians

Practitioners 7

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": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1750416319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5050 SANDERLIN AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381174332",
            "telephone_number": "901-507-6907",
            "fax_number": "901-761-1979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 SANDERLIN AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381174332",
            "telephone_number": "901-507-6907",
            "fax_number": "901-761-1979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAURELWOOD PEDIATRICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILLIAMSON",
        "authorized_official_first_name": "VIOLET",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "901-507-6907",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "ADMINISTRATOR"
    },
    "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 Aug 22, 2020; 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.