Active NPI
Tri-State Gastroenterology, P.C.
- Gastroenterology Physician
- Memphis, TN
National Provider Identifier
1972540953
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- Legal business name
- TRI-STATE GASTROENTEROLOGY, P.C.
- Practice address
- 1264 Wesley Dr
Suite 303
Memphis, TN 38116-6400 - Phone
- (901) 398-9574
- Fax
- (901) 398-9581
- NPI assigned
- May 31, 2006
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Gwendolyn Washington Jones
- Title
- Practice Manager
- Phone
- (901) 398-9574
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | Primary |
Addresses
Primary practice location
1264 Wesley Dr
Suite 303
Memphis, TN 38116-6400
Mailing address
1264 Wesley Dr
Suite 303
Memphis, TN 38116-6400
Phone (901) 398-9574
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN, MS
Enrollment records 2
National Provider Directory
National Provider DirectoryMember organizations 1
Organizations listed as members of this organization in the National Provider Directory.
Locations
1264 Wesley Dr
Ste 303
Memphis, TN 38116
Phone (901) 398-9574
Interoperability endpoints
- https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.72938
Practitioners & affiliated clinicians
Practitioners 1
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": "1149033600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1972540953",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1264 WESLEY DR",
"address_2": "SUITE 303",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381166400",
"telephone_number": "901-398-9574",
"fax_number": "901-398-9581"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1264 WESLEY DR",
"address_2": "SUITE 303",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381166400",
"telephone_number": "901-398-9574",
"fax_number": "901-398-9581"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TRI-STATE GASTROENTEROLOGY, P.C.",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-31",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "JONES",
"authorized_official_first_name": "GWENDOLYN",
"authorized_official_middle_name": "WASHINGTON",
"authorized_official_title_or_position": "PRACTICE MANAGER",
"authorized_official_telephone_number": "901-398-9574",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Gastroenterology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Memphis, TN
- Trezevant Episcopal Home (Allen Morgan Health & Rehabilitation Center)
- May Trezevant, PHARMD
- Tri State Community Health Center
- Tri State Community Health Center (Tri State Community Health Center Pharmacy)
- Tri-Med Pharmacy LLC (Orion Rx - Memphis)
- Tri-State Medical Management
- Tri-State Neurology PLLC
- Tri-State Orthopaedics, LLC
- Jada Anne Tribble, PA
- Trichocare Clinic
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.