Collierville Family Health PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

COLLIERVILLE FAMILY HEALTH PLLC

Practice address

2028 W Poplar Ave
Suite 115
Collierville, TN 38017-0618

Phone

(901) 221-8983

Fax

(901) 221-8985

NPI assigned

Feb 28, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Shoaib Qureshi, DONPI 1417056250

Title

Owner/ Sole Member

Phone

(901) 221-8983

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/ICJICA

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shoaib Qureshi, M.D

  • Family Medicine Physician
  • Memphis, TN
  • NPI 1417056250
  Medicare reassignment Care Compare group Authorized official
• Felicia Ann Gray-Hamilton, DNP, FNP-C

  • Family Nurse Practitioner
  • Collierville, TN
  • NPI 1164257481
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1330387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721952000000",
    "number": "1891069563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2028 W POPLAR AVE",
            "address_2": "SUITE 115",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380170618",
            "telephone_number": "901-221-8983",
            "fax_number": "901-221-8985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2028 W POPLAR AVE",
            "address_2": "SUITE 115",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380170618",
            "telephone_number": "901-221-8983",
            "fax_number": "901-221-8985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLIERVILLE FAMILY HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-28",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A",
        "authorized_official_last_name": "QURESHI",
        "authorized_official_first_name": "SHOAIB",
        "authorized_official_title_or_position": "OWNER/ SOLE MEMBER",
        "authorized_official_telephone_number": "901-221-8983",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Clark, DMD
• Stephanie Yau Cline, APRN, WHNP
• Gary Dean Clouse, DPT
• Lisa Collier
• Collierville Eyecare PLLC
• Collierville Family Medical Center P.C.
• Collierville Family Medicine PC
• Collierville Healthcare Corp
• Collierville Medical Assoc Inc
• Collierville Medical Specialists

• Family Medicine Physician in Collierville, TN
• Providers in Collierville, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.