NPIMap

Organization Active NPI

Memphis Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Rossville, TN
National Provider Identifier
1760780969
Registry record updated Jan 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
MEMPHIS HEALTH CENTER, INC.
Practice address
4940 Highway 57
Rossville, TN 38066-5068
Phone
(901) 261-7303
NPI assigned
Mar 11, 2011
Organization subpart
Yes
Parent organization
MEMPHIS HEALTH CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 23, 2023

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

Authorized official

Name
Aisha Barber
Title
Billing Director
Phone
(901) 261-2025

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

4940 Highway 57
Rossville, TN 38066-5068

Mailing address

360 E Eh Crump Blvd
Memphis, TN 38126-5310
Phone (901) 261-2002

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031103000245 TN Part B Supplier - Clinic/Group Practice 7315859972 Receives reassigned benefits from 80 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Memphis, TN; Rossville, TN
O20111219000131 TN Part A Provider - Federally Qualified Health Center (FQHC) 7315859972 Practice locations: Rossville, TN

Federally qualified health center certification: CCN 441850

Legal name
MEMPHIS HEALTH CENTER, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 1, 1991
Last certification
Oct 1, 1991
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Oct 1, 1991 in TN
Enrollment address
4940 Highway 57
Rossville, TN 38066-5068

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Memohis Health Center I5 organizations share this tax ID, including this one
Part of
Memohis Health Center I

Other organizations with this tax ID 4

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

Ownership & related parties

All disclosed owners & managing parties 8

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Theresa Isom Individual Corporate DirectorBoard Member Jan 1, 2011
Marilyn Burress Individual Corporate OfficerChief Executive Officer Aug 1, 2020
Lois Stockton Individual Corporate DirectorBoard Member Jan 1, 2011
Aisha Barber Individual W-2 Managing EmployeeBilling Manager Mar 1, 2020
Binder Jones Individual Corporate DirectorBoard Member Jul 12, 2014
Howard Demesma Individual Corporate DirectorBoard Member Jan 1, 2011
Coleman Thompson Individual Corporate DirectorBoard Member Jan 1, 2011
Dorothette White Individual Corporate DirectorCfo Mar 24, 2023

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": "1299801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674432000000",
    "number": "1760780969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 E EH CRUMP BLVD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381265310",
            "telephone_number": "901-261-2002",
            "fax_number": "901-946-9262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4940 HIGHWAY 57",
            "city": "ROSSVILLE",
            "state": "TN",
            "postal_code": "380665068",
            "telephone_number": "901-261-7303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMPHIS HEALTH CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEMPHIS HEALTH CENTER",
        "enumeration_date": "2011-03-11",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A",
        "authorized_official_last_name": "BARBER",
        "authorized_official_first_name": "AISHA",
        "authorized_official_title_or_position": "BILLING DIRECTOR",
        "authorized_official_telephone_number": "901-261-2025"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rossville, TN

Sources for this page

Verify at the official NPI Registry.