Pediatric Neurology

Primary specialty

Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X

Legal business name

PEDIATRIC NEUROLOGY

Practice address

7645 Wolf River Cir
Germantown, TN 38138-1751

Phone

(901) 405-0275

NPI assigned

Jan 3, 2007

Organization subpart

No

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

Authorized official

Name

Loretta Mosiej Brown

Title

Office Administrator

Phone

(901) 405-0275

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211155200000",
    "number": "1811054372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7645 WOLF RIVER CIR",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381381751",
            "telephone_number": "901-405-0275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7645 WOLF RIVER CIR",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381381751",
            "telephone_number": "901-405-0275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC NEUROLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2008-05-19",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "LORETTA",
        "authorized_official_middle_name": "MOSIEJ",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "901-405-0275"
    },
    "taxonomies": [
        {
            "code": "2080P0006X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurodevelopmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Basil Mantas Paulus, M.D.
• Robin Payton
• Peak Potential Physiotherapy and Wellness
• Amanda Davidson Pearson, AUD
• Richard McQuiston Pearson, M.D.
• Pediatric Rehab Services, PC
• Pediatric Urology Associates of the Mid-South, P.C.
• Phillip A Pedigo, M.D.
• Frederick R Pelz, MD
• Joel Evan Perchik, M.D.

• Neurology with Special Qualifications in Child Neurology Physician in Germantown, TN
• Providers in Germantown, TN by specialty
• Neurology with Special Qualifications in Child Neurology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2008; 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.