Active NPI
Clarice Weathers Mullinax, M.D.
- Family Medicine Physician
- Memphis, TN
National Provider Identifier
1871541177
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD0000036835
- Practice address
- 3124 North Thomas Street
Christ Community Health Services Inc
Memphis, TN 38127 - Phone
- (901) 260-8400
- Fax
- (901) 260-8590
- NPI assigned
- May 5, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD0000036835 | TN | Primary |
Addresses
Primary practice location
3124 North Thomas Street
Christ Community Health Services Inc
Memphis, TN 38127
Mailing address
2595 Central Ave
Christ Community Health Services Inc
Memphis, TN 38104-5905
Phone (901) 260-8500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3879609 | Medicaid | TN |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD0000036835 | TN | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323734400000",
"number": "1871541177",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2595 CENTRAL AVE",
"address_2": "CHRIST COMMUNITY HEALTH SERVICES INC",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381045905",
"telephone_number": "901-260-8500",
"fax_number": "901-260-8590"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3124 NORTH THOMAS STREET",
"address_2": "CHRIST COMMUNITY HEALTH SERVICES INC",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "38127",
"telephone_number": "901-260-8400",
"fax_number": "901-260-8590"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULLINAX",
"first_name": "CLARICE",
"middle_name": "WEATHERS",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-05",
"last_updated": "2011-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TN",
"license": "MD0000036835",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3879609",
"state": "TN"
}
],
"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 Dec 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.