Organization Active NPI

Medical Care of Tennessee PLLC

  • General Practice Physician
  • Memphis, TN
National Provider Identifier
1982366779
Registry record updated Apr 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
MEDICAL CARE OF TENNESSEE PLLC
Practice address
1407 Union Ave
Memphis, TN 38104-3627
Phone
(901) 674-8230
NPI assigned
Oct 8, 2021
Last updated
Apr 22, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2022

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

Authorized official

Name
Joseph N De Vera
Title
Manager Member
Phone
(901) 674-8230

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X NU Primary

Addresses

Primary practice location

1407 Union Ave
Memphis, TN 38104-3627

Mailing address

1407 Union Ave
Memphis, TN 38104-3627
Phone (901) 674-8230

National Provider Directory

National Provider Directory

Locations

1407 Union Ave
Memphis, TN 38104
Phone (877) 258-8795

1407 Union Ave
Ste 305
Memphis, TN 38104
Phone (901) 609-2444

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1633651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650585600000",
    "number": "1982366779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1407 UNION AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381043627",
            "telephone_number": "901-674-8230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1407 UNION AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381043627",
            "telephone_number": "901-674-8230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL CARE OF TENNESSEE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-08",
        "last_updated": "2022-04-22",
        "certification_date": "2022-04-22",
        "status": "A",
        "authorized_official_last_name": "DE VERA",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "MANAGER MEMBER",
        "authorized_official_telephone_number": "901-674-8230"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "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 22, 2022; 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.