Individual provider Active NPI

Lakesha A Tables, MD

  • Pediatric Emergency Medicine (Emergency Medicine) Physician
  • Memphis, TN
National Provider Identifier
1962518217
Registry record updated Mar 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Emergency Medicine) PhysicianTaxonomy code 207PP0204X
License
41223 Issued in TN
Practice address
50 N Dunlap St
Memphis, TN 38103-2800
Phone
(901) 405-1407
NPI assigned
Aug 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Emergency Medicine) Physician 207PP0204X 41223 TN Primary

Addresses

Primary practice location

50 N Dunlap St
Memphis, TN 38103-2800

Mailing address

8010 Stage Hills Blvd
Bartlett, TN 38133-4032
Phone (901) 291-2400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20191024000496 GA Practitioner - Pediatric Medicine 6305844606 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41223TNMDPediatric Emergency Medicine (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Morehouse Healthcare, Inc. CurrentSince Aug 1, 2019 Accepting new patients
Pediatric Emergency Specialists, PC Pediatric Emergency Medicine Past Accepting new patients

Locations

455 Lee St SW
Fl 2
Atlanta, GA 30310
Phone (404) 756-1241

1800 Howell Mill Rd NW
Ste 550
Atlanta, GA 30318
Phone (404) 756-1290

35 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 785-9500

720 Westview Dr SW
Ste 100A
Atlanta, GA 30310

1595 Cleveland Ave
East Point, GA 30344
Phone (404) 305-8086

Interoperability endpoints

  • Direct secure messaging: ltables2946067@carolinashealthcaresystem.direct-ci.com
  • Direct secure messaging: lakesha.tables.1@10414.direct.athenahealth.com

Organizations & group practices 2

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": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332460800000",
    "number": "1962518217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8010 STAGE HILLS BLVD",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381334032",
            "telephone_number": "901-291-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 N DUNLAP ST",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381032800",
            "telephone_number": "901-405-1407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABLES",
        "first_name": "LAKESHA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2012-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "TN",
            "license": "41223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.