Individual provider Active NPI

Mark L Hammond, M.D.

  • Internal Medicine Physician
  • Memphis, TN
National Provider Identifier
1861417164
Registry record updated Oct 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD15646 Issued in TN
Practice address
6263 Poplar Ave
#1052
Memphis, TN 38119-4701
Phone
(901) 844-1431
Fax
(901) 761-4145
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD15646 TN Primary

Addresses

Primary practice location

6263 Poplar Ave
#1052
Memphis, TN 38119-4701

Mailing address

PO Box 383227
Germantown, TN 38183-3227
Phone (901) 844-1431

Other identifiers 3

IdentifierTypeStateIssuer
00116351MedicaidMS
3010268MedicaidTN
4069880OtherTNBCBS

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101203000059 TN Practitioner - Internal Medicine 4880881812 Practice locations: Germantown, TN

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Tennessee, HSC, College of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7691 Poplar Ave
Germantown, TN 38138-3904
Phone (901) 844-2500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
15646TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Healthcare - Memphis Hospitals Past Accepting new patients
Methodist Healthcare - Memphis Hospitals Past Accepting new patients
Methodist Healthcare - Memphis Hospitals Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mhammond30448@mlh.direct-ci.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665705600000",
    "number": "1861417164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 383227",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381833227",
            "telephone_number": "901-844-1431",
            "fax_number": "901-761-4145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6263 POPLAR AVE",
            "address_2": "#1052",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381194701",
            "telephone_number": "901-844-1431",
            "fax_number": "901-761-4145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMMOND",
        "first_name": "MARK",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD15646",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00116351",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3010268",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4069880",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.