Individual provider Active NPI

Yigrem Engida

  • Driver
  • Memphis, TN
National Provider Identifier
1861917668
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DriverTaxonomy code 172A00000X
License
089714532 Issued in TN
Practice address
119 Racine St Ste 103
Memphis, TN 38111-2729
Phone
(901) 239-4105
NPI assigned
Aug 14, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Driver 172A00000X 089714532 TN Primary

Addresses

Primary practice location

119 Racine St Ste 103
Memphis, TN 38111-2729

Mailing address

119 Racine St Ste 103
Memphis, TN 38111-2729
Phone (901) 239-4105

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
089714532TNMDDriver

NPI Registry JSON

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

{
    "created_epoch": "1502668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1861917668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 RACINE ST STE 103",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381112729",
            "telephone_number": "901-239-4105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 RACINE ST STE 103",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381112729",
            "telephone_number": "901-239-4105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGIDA",
        "first_name": "YIGREM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-14",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "TN",
            "license": "089714532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • 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.