Organization Active NPI

Memphis Infectious Diseases Consultants, PLLC

  • Infectious Disease Physician
  • Memphis, TN
National Provider Identifier
1962554840
Registry record updated Apr 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
Legal business name
MEMPHIS INFECTIOUS DISEASES CONSULTANTS, PLLC
Practice address
1331 Union Ave Ste 1008
Memphis, TN 38104-7567
Phone
(901) 881-3554
Fax
(901) 620-5500
NPI assigned
Jan 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2023

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

Authorized official

Name
Dr. Vladimir Chachanidze, M.D.NPI 1750327607
Title
Partner
Phone
(901) 881-3554

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RI0200X Primary

Addresses

Primary practice location

1331 Union Ave Ste 1008
Memphis, TN 38104-7567

Mailing address

1331 Union Ave Ste 1008
Memphis, TN 38104-7567
Phone (901) 881-3554

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050721000639 TN Part B Supplier - Clinic/Group Practice 4082641923 Receives reassigned benefits from 1 practitioner
Practice locations: Memphis, TN

National Provider Directory

National Provider Directory

Locations

1331 Union Ave
Ste 1008
Memphis, TN 38104
Phone (901) 881-3554

1331 Union Ave
Ste 1023
Memphis, TN 38104
Phone (901) 881-3554

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681776000000",
    "number": "1962554840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1331 UNION AVE STE 1008",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381047567",
            "telephone_number": "901-881-3554",
            "fax_number": "901-620-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1331 UNION AVE STE 1008",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381047567",
            "telephone_number": "901-881-3554",
            "fax_number": "901-620-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMPHIS INFECTIOUS DISEASES CONSULTANTS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2023-04-18",
        "certification_date": "2023-04-18",
        "status": "A",
        "authorized_official_last_name": "CHACHANIDZE",
        "authorized_official_first_name": "VLADIMIR",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "901-881-3554",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Apr 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.