Mid South Pain & Anesthesia Clinic Inc

Primary specialty

SpecialistTaxonomy code 174400000X

License

MD0000017865 Issued in TN

Legal business name

MID SOUTH PAIN & ANESTHESIA CLINIC INC

Practice address

3087 Professional PLZ
Germantown, TN 38138-7912

Phone

(901) 761-0800

NPI assigned

Jan 29, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Phillip E Green, MDNPI 1639175037

Title

Owner

Phone

(901) 761-0800

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MS, TN, AR3 enrollments

Enrollment records 3

Locations

Practitioners 2

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

• Phillip Edward Green, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Memphis, TN
  • NPI 1639175037

  AR, MS

  Medicare reassignment NPD Authorized official
• Kristen Marie Watson, DO

  • Anesthesiology Physician
  • Memphis, TN
  • NPI 1437317971
  Medicare reassignment NPD

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626739200000",
    "number": "1841336583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 382067",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381832067",
            "telephone_number": "901-761-0800",
            "fax_number": "901-761-7738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3087 PROFESSIONAL PLZ",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381387912",
            "telephone_number": "901-761-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID SOUTH PAIN & ANESTHESIA CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "901-761-0800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "TN",
            "license": "MD0000017865",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3722886",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00586809",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brittany Mezquita, NP
• Michael E. Steuer MD PC
• Michael P. Berry, MD, PC
• Mid South Endodontics PLLC
• Mid South Neurology Clinic PLLC
• Mid South Pain & Anesthesia Clinic, Inc.
• Mid South Radiation Oncology Center, LLC
• Mid-South Cancer Center
• Mid-South Ear, Nose, and Throat, P.C.
• Mid-South Ear, Nose, and Throat, P.C.

• Specialist in Germantown, TN
• Providers in Germantown, TN by specialty
• Specialist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2021; 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.