Midsouth Independent Group, PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

MIDSOUTH INDEPENDENT GROUP, PLLC

Practice address

6401 Poplar Ave Ste 604
Memphis, TN 38119-4808

Phone

(901) 474-2402

Fax

(901) 328-5746

NPI assigned

Sep 29, 2020

Last updated

Nov 29, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. William R Breen Jr.

Title

Group Manager

Phone

(901) 832-4494

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 40

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Patricia Ar Arangie, APRN PHD

  • Family Nurse Practitioner
  • Bartlett, TN
  • NPI 1114043791
  Medicare reassignment NPD
• Joy C Burbeck, M.D.

  • Pulmonary Disease Physician
  • Collierville, TN
  • NPI 1578569034
  Medicare reassignment NPD
• Farah F Cardosi, DNP

  • Family Nurse Practitioner
  • Germantown, TN
  • NPI 1235667965
  Medicare reassignment NPD
• Judy Gayle Cole, N.P.

  • Family Medicine Physician
  • McMinnville, TN
  • NPI 1952454332
  Medicare reassignment NPD
• Angela B Cursey, NURSE PRACT

  • Nurse Practitioner
  • Martin, TN
  • NPI 1912007469
  Medicare reassignment NPD
• Monisha Dutta, M.D.

  • Neurology Physician
  • Memphis, TN
  • NPI 1164634978
  Medicare reassignment NPD
• Barbara P Evangelisti, NP-C

  • Family Nurse Practitioner
  • Bartlett, TN
  • NPI 1871700658
  Medicare reassignment NPD
• Linda A Foster, M.D.

  • Family Medicine Physician
  • McMinnville, TN
  • NPI 1528055381
  Medicare reassignment NPD
• Barbara Ella Geater, MD

  • Family Medicine Physician
  • Memphis, TN
  • NPI 1679509707
  Medicare reassignment NPD
• Krystal B Goodwin, APN

  • Family Nurse Practitioner
  • Collierville, TN
  • NPI 1093250318
  Medicare reassignment NPD
• Shawn Joseph Hayden, M.D.

  • Internal Medicine Physician
  • Memphis, TN
  • NPI 1609835909
  Medicare reassignment NPD
• Tamara Howard-Fain, APRN, BC

  • Family Nurse Practitioner
  • Memphis, TN
  • NPI 1932262417
  Medicare reassignment NPD

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

{
    "created_epoch": "1601337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701216000000",
    "number": "1861009326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6401 POPLAR AVE STE 604",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381194808",
            "telephone_number": "901-474-2402",
            "fax_number": "901-249-4070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6401 POPLAR AVE STE 604",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381194808",
            "telephone_number": "901-474-2402",
            "fax_number": "901-328-5746"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "740 Bartlett Rd",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381223004",
            "country_code": "US",
            "telephone_number": "901-685-8202",
            "fax_number": "901-682-3525",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "491A Craft St",
            "address_purpose": "LOCATION",
            "city": "Holly Springs",
            "state": "MS",
            "postal_code": "386353251",
            "country_code": "US",
            "telephone_number": "662-252-6416",
            "fax_number": "662-252-3355",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "164 Mount Pelia Rd",
            "address_purpose": "LOCATION",
            "city": "Martin",
            "state": "TN",
            "postal_code": "382373812",
            "country_code": "US",
            "telephone_number": "731-587-5900",
            "fax_number": "731-587-5908",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6401 Poplar Ave Ste 600",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381194808",
            "country_code": "US",
            "telephone_number": "901-525-3086",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "728 W Sherrod Ave",
            "address_purpose": "LOCATION",
            "city": "Covington",
            "state": "TN",
            "postal_code": "380193024",
            "country_code": "US",
            "telephone_number": "901-476-7779",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2245 S Lauderdale St",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381067517",
            "country_code": "US",
            "telephone_number": "901-948-5558",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1785 Nonconnah Blvd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381322112",
            "country_code": "US",
            "telephone_number": "901-345-6700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "943 Whitney Ave",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381277734",
            "country_code": "US",
            "telephone_number": "901-358-0326",
            "fax_number": "901-358-9010",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2018 McIngvale Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Hernando",
            "state": "MS",
            "postal_code": "386328706",
            "country_code": "US",
            "telephone_number": "662-354-5667",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MIDSOUTH INDEPENDENT GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-29",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A",
        "authorized_official_last_name": "BREEN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "GROUP MANAGER",
        "authorized_official_telephone_number": "901-832-4494",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q061176",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Alan Middleton, PHARMD
• Thomas M Middleton Jr., LPC
• David Michael Midlick Jr.
• Midsouth Family Care PLLC
• Midsouth Healthcare Management
• Midsouth Internists, PC
• Midsouth Mental Health LLC
• Midsouth Mental Health Services, Inc
• Midsouth Neurology Clinic PLLC
• Midsouth Neuropathy Treatment Center

• Internal Medicine Physician in Memphis, TN
• Providers in Memphis, TN by specialty
• Internal Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.