Geriatric and Hospice Associates of the Mid South PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

GERIATRIC AND HOSPICE ASSOCIATES OF THE MID SOUTH PLLC

Practice address

6025 Walnut Grove Rd Ste 317
Memphis, TN 38120-2131

Phone

(901) 818-3921

Fax

(901) 767-3056

NPI assigned

Nov 7, 2019

Last updated

Nov 15, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Randy Villanueva, MDNPI 1083666234

Title

President

Phone

(901) 818-3921

Specialties & licenses 3

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Randy Joseph Villanueva, MD

  • Internal Medicine Physician
  • Memphis, TN
  • NPI 1083666234
  Authorized official Same address or phone

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

{
    "created_epoch": "1573084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573776000000",
    "number": "1801431499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6799 GREAT OAKS RD STE 250",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381382584",
            "telephone_number": "901-261-0700",
            "fax_number": "901-261-0701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6025 WALNUT GROVE RD STE 317",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202131",
            "telephone_number": "901-818-3921",
            "fax_number": "901-767-3056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERIATRIC AND HOSPICE ASSOCIATES OF THE MID SOUTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-07",
        "last_updated": "2019-11-15",
        "status": "A",
        "authorized_official_last_name": "VILLANUEVA",
        "authorized_official_first_name": "RANDY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "901-818-3921",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lloyd A George, D.D.S.
• Dongmo Georgette Tekobo
• Georgia's Divine Home Care LLC
• Therese Geraci
• Brittany Gerald
• Geriatric Group of Memphis,PLLC
• Geriatric Partners, LLC
• Geriatric Wellness Physicians LLC
• Geriatrics & Palliative Care PLLC
• Geriatrics Group of Memphis

• Internal Medicine Physician in Memphis, TN
• Providers in Memphis, TN by specialty
• Internal Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2019; 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.