NPIMap

Organization Active NPI

University of TN Cytogenetics Lab-Memphis

  • Clinical Medical Laboratory
  • Memphis, TN
National Provider Identifier
1770798332
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
0000002103 Issued in TN
Legal business name
UNIVERSITY OF TN CYTOGENETICS LAB-MEMPHIS
Practice address
711 Jefferson Ave
Suite 523
Memphis, TN 38105-5003
Phone
(901) 448-6676
Fax
(901) 448-4117
NPI assigned
May 14, 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
Dr. Avirachan Tharapel, PH.D.
Title
Director, Cytogenetics Laboratory
Phone
(901) 448-6676

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 0000002103 TN Primary

Addresses

Primary practice location

711 Jefferson Ave
Suite 523
Memphis, TN 38105-5003

Mailing address

711 Jefferson Ave
Suite 523
Memphis, TN 38105-5003
Phone (901) 448-6676

Other identifiers 1

IdentifierTypeStateIssuer
3402016MedicaidTN

National Provider Directory

National Provider Directory
Tax ID family
Ut CT HLTH SC Fam Prac CT26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

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

View all 25

Locations

711 Jefferson Ave
Ste 523
Memphis, TN 38105
Phone (901) 448-6676

NPI Registry JSON

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1770798332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 JEFFERSON AVE",
            "address_2": "SUITE 523",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381055003",
            "telephone_number": "901-448-6676",
            "fax_number": "901-448-4117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 JEFFERSON AVE",
            "address_2": "SUITE 523",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381055003",
            "telephone_number": "901-448-6676",
            "fax_number": "901-448-4117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF TN CYTOGENETICS LAB-MEMPHIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "THARAPEL",
        "authorized_official_first_name": "AVIRACHAN",
        "authorized_official_title_or_position": "DIRECTOR, CYTOGENETICS LABORATORY",
        "authorized_official_telephone_number": "901-448-6676",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "TN",
            "license": "0000002103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3402016",
            "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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.