Active NPI
Molly Krystine McEwen, MD
- Pediatrics Physician
- Memphis, TN
National Provider Identifier
1821595737
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 28724
- Practice address
- 1129 Hale Rd
Memphis, TN 38116-6373 - Phone
- (901) 396-0390
- NPI assigned
- Apr 7, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatrics Physician | 208000000X | 28724 | MS | Primary |
Addresses
Primary practice location
1129 Hale Rd
Memphis, TN 38116-6373
Mailing address
1129 Hale Rd
Memphis, TN 38116-6373
Phone (901) 396-0390
Other practice location 1
920 Madison Ave Ste 447
Memphis, TN 38103-3438
Phone (901) 287-6756
Other names 1
- Miss Molly Krystine Morgan
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180823001433 | TN | Order and Referring Only - Pediatric Medicine | 3173872199 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28724 | MS | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1523059200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624838400000",
"number": "1821595737",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1129 HALE RD",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381166373",
"telephone_number": "901-396-0390"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1129 HALE RD",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381166373",
"telephone_number": "901-396-0390"
}
],
"practiceLocations": [
{
"address_1": "920 Madison Ave Ste 447",
"address_purpose": "LOCATION",
"city": "Memphis",
"state": "TN",
"postal_code": "381033438",
"country_code": "US",
"telephone_number": "901-287-6756",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCEWEN",
"first_name": "MOLLY",
"middle_name": "KRYSTINE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-04-07",
"last_updated": "2021-06-28",
"certification_date": "2021-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MS",
"license": "28724",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MOLLY",
"last_name": "MORGAN",
"middle_name": "KRYSTINE",
"prefix": "MISS",
"code": "1",
"type": "Former Name"
}
]
}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 Jun 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.