Ageless Women's Health TN LLC

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

Legal business name

AGELESS WOMEN'S HEALTH TN LLC

Practice address

1374 Cordova CV Ste 102
Germantown, TN 38138-2220

Phone

(901) 522-6745

NPI assigned

Jul 8, 2024

Last updated

Jul 8, 2024By 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

Teah Phillips

Title

Credentialing Manager

Phone

(901) 205-3999

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1720396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720396800000",
    "number": "1861238834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1374 CORDOVA CV STE 102",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381382220",
            "telephone_number": "901-522-6745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1374 CORDOVA CV STE 102",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381382220",
            "telephone_number": "901-522-6745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGELESS WOMEN'S HEALTH TN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-08",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "TEAH",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "901-205-3999"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Medicine Physician in Germantown, TN
• Providers in Germantown, TN by specialty
• Adult Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; 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.