Individual provider Active NPI

Paul Molloy, D.O.

  • Neonatal-Perinatal Medicine Physician
  • Germantown, TN
National Provider Identifier
1861929531
Registry record updated Aug 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
4505 Issued in TN
Practice address
7691 Poplar Ave
Germantown, TN 38138-3904
Phone
(901) 516-6000
NPI assigned
May 12, 2017
Last updated
Aug 21, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 4505 TN Primary

Addresses

Primary practice location

7691 Poplar Ave
Germantown, TN 38138-3904

Mailing address

2456 Brandemere Dr
Germantown, TN 38139-6310
Phone (901) 303-5100

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170621001592 TN Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 0547538209

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4505TNMDOccupational Therapist

Interoperability endpoints

  • Direct secure messaging: pmolloy31762@mlh.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1494547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1861929531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2456 BRANDEMERE DR",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381396310",
            "telephone_number": "901-303-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7691 POPLAR AVE",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381383904",
            "telephone_number": "901-516-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLLOY",
        "first_name": "PAUL",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-12",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "TN",
            "license": "4505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, TN

Sources for this page

Verify at the official NPI Registry.