NPIMap

Organization Active NPI

Memphis Lung Physicians Foundation, Inc.

  • Pulmonary Disease Physician
  • Germantown, TN
National Provider Identifier
1811279656
Registry record updated Feb 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
MEMPHIS LUNG PHYSICIANS FOUNDATION, INC.
Practice address
2120 Exeter Rd Ste 250
Germantown, TN 38138-3931
Phone
(901) 767-5864
NPI assigned
Sep 19, 2011
Organization subpart
Yes
Parent organization
BAPTIST MEMORIAL HEALTH CARE CORP.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 14, 2022

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

Authorized official

Name
Gregory M Duckett
Title
Sr VP/ Clo
Phone
(901) 227-5233

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0200X
Pulmonary Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RP1001X Primary
Sleep Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RS0012X
Surgical Critical Care PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0102X
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Acute Care Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LA2100X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X
Gerontology Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LG0600X

Addresses

Primary practice location

2120 Exeter Rd Ste 250
Germantown, TN 38138-3931

Mailing address

350 N Humphreys Blvd
Memphis, TN 38120-2177
Phone (901) 767-5864

Other practice location 1

401 Southcrest Cir Ste 212
Southaven, MS 38671-6721
Phone (662) 349-0488

Other practice location 2

1500 W Poplar Ave Ste 309
Collierville, TN 38017-0601
Phone (901) 850-1170

Other practice location 3

6025 Walnut Grove Rd
Suite 508
Memphis, TN 38120-2131
Phone (901) 767-5864

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20111007000197 TN Part B Supplier - Clinic/Group Practice 4981876307 Receives reassigned benefits from 68 practitioners
Practice locations: Memphis, TN; Germantown, TN; Covington, TN; Collierville, TN; Atoka, TN
O20111018000548 MS Part B Supplier - Clinic/Group Practice 4981876307 Receives reassigned benefits from 50 practitioners
Practice locations: Southaven, MS

National Provider Directory

National Provider Directory
Part of
Baptist Memorial Health Care Corp

Locations

401 Southcrest Cir
Ste 212
Southaven, MS 38671
Phone (662) 245-5270

1500 W Poplar Ave
#309
Collierville, TN 38017
Phone (901) 767-5864

1500 W Poplar Ave
Ste 309
Collierville, TN 38017
Phone (901) 767-5864

6025 Walnut Grove Rd
Ste 508
Memphis, TN 38120
Phone (901) 767-5864

2120 Exeter Rd
Ste 250
Memphis, TN 38138
Phone (901) 767-5864

6215 Humphreys Blvd
Ste 301
Memphis, TN 38120
Phone (901) 227-9870

Practitioners & affiliated clinicians

Practitioners 74

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 74

NPI Registry JSON

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

{
    "created_epoch": "1316390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644796800000",
    "number": "1811279656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 N HUMPHREYS BLVD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202177",
            "telephone_number": "901-767-5864",
            "fax_number": "901-767-6591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 EXETER RD STE 250",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381383931",
            "telephone_number": "901-767-5864"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 Southcrest Cir Ste 212",
            "address_purpose": "LOCATION",
            "city": "Southaven",
            "state": "MS",
            "postal_code": "386716721",
            "country_code": "US",
            "telephone_number": "662-349-0488",
            "fax_number": "662-349-5974",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1500 W Poplar Ave Ste 309",
            "address_purpose": "LOCATION",
            "city": "Collierville",
            "state": "TN",
            "postal_code": "380170601",
            "country_code": "US",
            "telephone_number": "901-850-1170",
            "fax_number": "901-850-1169",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6025 Walnut Grove Rd",
            "address_2": "SUITE 508",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381202131",
            "country_code": "US",
            "telephone_number": "901-767-5864",
            "fax_number": "901-767-6591",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MEMPHIS LUNG PHYSICIANS FOUNDATION, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BAPTIST MEMORIAL HEALTH CARE CORP.",
        "enumeration_date": "2011-09-19",
        "last_updated": "2022-02-14",
        "certification_date": "2022-02-09",
        "status": "A",
        "authorized_official_last_name": "DUCKETT",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SR VP/ CLO",
        "authorized_official_telephone_number": "901-227-5233"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Surgical Critical Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Acute Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.