Individual provider Active NPI

Shahnoor Afreen Hussain, DO

  • Student in an Organized Health Care Education/Training Program
  • Memphis, TN
National Provider Identifier
1871120964
Registry record updated Jun 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
51 N Dunlap St
Memphis, TN 38105-4625
Phone
(901) 287-7337
Fax
(901) 287-5506
NPI assigned
Mar 26, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

51 N Dunlap St
Memphis, TN 38105-4625

Mailing address

840 S Wood St RM 1403
Chicago, IL 60612-4325
Phone (312) 996-6043

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
I20241114002524 TN Practitioner - Pediatric Medicine 4789002361 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5787TNMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Lebonheur Pediatric Specialists, Inc. CurrentSince Nov 1, 2024 Accepting new patients

Locations

850 Poplar Ave
Bldg 2
Memphis, TN 38105
Phone (901) 287-5594

848 Adams Ave
Memphis, TN 38103
Phone (901) 287-5437

100 N Humphreys Blvd
Memphis, TN 38120
Phone (901) 747-1800

Interoperability endpoints

  • Direct secure messaging: shussain69322@uihealth.direct-ci.com
  • Direct secure messaging: shussain102483@mlh.direct-ci.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719446400000",
    "number": "1871120964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 S WOOD ST RM 1403",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124325",
            "telephone_number": "312-996-6043",
            "fax_number": "312-413-0243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 N DUNLAP ST",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381054625",
            "telephone_number": "901-287-7337",
            "fax_number": "901-287-5506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUSSAIN",
        "first_name": "SHAHNOOR",
        "middle_name": "AFREEN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-26",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.