The Medical Group of Memphis LLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

THE MEDICAL GROUP OF MEMPHIS LLC

Practice address

1500 W Poplar Ave
#308
Collierville, TN 38017-0601

Phone

(901) 414-0017

NPI assigned

Jan 5, 2007

Organization subpart

No

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

Authorized official

Name

Roger Struble

Title

Ceo

Phone

(901) 725-8603

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1831246396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 W POPLAR AVE",
            "address_2": "#308",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380170601",
            "telephone_number": "901-414-0017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 W POPLAR AVE",
            "address_2": "#308",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380170601",
            "telephone_number": "901-414-0017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MEDICAL GROUP OF MEMPHIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-05",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "STRUBLE",
        "authorized_official_first_name": "ROGER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "901-725-8603"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "TN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.