NPIMap

Individual provider Active NPI

Perisco A Wofford, MD

  • Internal Medicine Physician
  • Memphis, TN
National Provider Identifier
1922000918
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD0000037436 Issued in TN
Practice address
4567 Millbranch Rd
Memphis, TN 38116-7437
Phone
(901) 345-1454
Fax
(901) 345-1456
NPI assigned
Aug 10, 2005
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 37436 TN
Internal Medicine Physician 207R00000X MD0000037436 TN Primary

Addresses

Primary practice location

4567 Millbranch Rd
Memphis, TN 38116-7437

Mailing address

4567 Millbranch Rd
Memphis, TN 38116-7437
Phone (901) 034-5145

Other identifiers 1

IdentifierTypeStateIssuer
3886982MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081009000227 TN Practitioner - Emergency Medicine 1951374164 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Mississippi School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4567 Millbranch Rd
Memphis, TN 38116-7437
Phone (901) 345-1454

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
38.17 of 100Reported as individual
Quality
56.35
Improvement activities
0

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
C. Ferrell Varner MD, Inc. Emergency Medicine Past Accepting new patients
Hugh Hermes Williams M D Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: pwofford15360@direct.bmhcc.org
  • Direct secure messaging: pwofford31885@mlh.direct-ci.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1922000918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4567 MILLBRANCH RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381167437",
            "telephone_number": "901-034-5145",
            "fax_number": "901-345-1456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4567 MILLBRANCH RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381167437",
            "telephone_number": "901-345-1454",
            "fax_number": "901-345-1456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOFFORD",
        "first_name": "PERISCO",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "37436",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD0000037436",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3886982",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.