Organization Active NPI

Family Cancer Center, PLLC

  • Hematology & Oncology Physician
  • Bartlett, TN
National Provider Identifier
1912911611
Registry record updated Mar 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
MD0000015925 Issued in TN
Legal business name
FAMILY CANCER CENTER, PLLC
Practice address
2996 Kate Bond
Suite 207
Bartlett, TN 38133-4062
Phone
(901) 379-0703
Fax
(901) 379-0532
NPI assigned
Jul 28, 2006
Last updated
Mar 9, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2011

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

Authorized official

Name
William K Walsh, M.D.NPI 1982602785
Title
Managing Physician
Phone
(901) 685-5655

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 19652 TN
Hematology (Internal Medicine) Physician 207RH0000X MD0000015925 TN
Hematology & Oncology Physician 207RH0003X MD0000015925 TN Primary

Addresses

Primary practice location

2996 Kate Bond
Suite 207
Bartlett, TN 38133-4062

Mailing address

P.O. Box 5111
Memphis, TN 38101-5111
Phone (901) 685-5655

Other identifiers 5

IdentifierTypeStateIssuer
090015910MedicaidMS
4035183OtherTNBCBS
CG9522OtherTNRRMCR
135396002MedicaidAR
3723894MedicaidTN

National Provider Directory

National Provider Directory

Locations

1940 W Poplar Ave
Collierville, TN 38017

440 Wilkinson Dr
Dyersburg, TN 38024
Phone (731) 285-2211

6005 Park Ave
Ste 725
Memphis, TN 38119
Phone (901) 685-5655

1720 E Reelfoot Ave
Ste 200
Union City, TN 38261
Phone (731) 507-0272

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299628800000",
    "number": "1912911611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 5111",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381015111",
            "telephone_number": "901-685-5655",
            "fax_number": "901-685-2590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2996 KATE BOND",
            "address_2": "SUITE 207",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381334062",
            "telephone_number": "901-379-0703",
            "fax_number": "901-379-0532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY CANCER CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-28",
        "last_updated": "2011-03-09",
        "status": "A",
        "authorized_official_last_name": "WALSH",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MANAGING PHYSICIAN",
        "authorized_official_telephone_number": "901-685-5655",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TN",
            "license": "19652",
            "primary": false
        },
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "TN",
            "license": "MD0000015925",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "TN",
            "license": "MD0000015925",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "090015910",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4035183",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMCR",
            "identifier": "CG9522",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135396002",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3723894",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bartlett, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 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.

Verify at the official NPI Registry.