{ "result_count": 54, "results": [ { "addresses": [ { "address_1": "DEPT. 453 PO BOX 1000", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "828-350-2174", "postal_code": "381480001", "state": "TN", "telephone_number": "828-575-2625" }, { "address_1": "2615 LAKE DR STE 301", "address_purpose": "LOCATION", "address_type": "DOM", "city": "RALEIGH", "country_code": "US", "country_name": "United States", "fax_number": "919-783-9406", "postal_code": "276076694", "state": "NC", "telephone_number": "919-787-5995" } ], "basic": { "certification_date": "2023-10-31", "credential": "M.D.", "enumeration_date": "2005-07-07", "first_name": "ALAN", "last_name": "AARONS", "last_updated": "2023-10-31", "middle_name": "LAWRENCE", "sex": "M", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1120751919000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "1578560363", "issuer": null, "state": "NC" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "NCS078A", "issuer": "Medicare PTAN", "state": "NC" } ], "last_updated_epoch": "1698757213000", "number": "1578560363", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207K00000X", "desc": "Allergy & Immunology", "license": "38886", "primary": true, "state": "NC", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "6139 CHAPELLE CIR W", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-757-6109", "postal_code": "381204062", "state": "TN", "telephone_number": "901-757-6100" }, { "address_1": "6401 POPLAR AVE STE 300", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-757-6109", "postal_code": "381194810", "state": "TN", "telephone_number": "901-757-6100" } ], "basic": { "authorized_official_first_name": "MELANIE", "authorized_official_last_name": "BLACK", "authorized_official_middle_name": "A", "authorized_official_name_prefix": "Ms.", "authorized_official_telephone_number": "9017576100", "authorized_official_title_or_position": "Administrator", "enumeration_date": "2018-06-28", "last_updated": "2018-06-28", "organization_name": "ALLERGY ASTHMA IMMUNOLOGY CENTER, PLLC", "organizational_subpart": "NO", "status": "A" }, "created_epoch": "1530217353000", "endpoints": [], "enumeration_type": "NPI-2", "identifiers": [], "last_updated_epoch": "1530217353000", "number": "1417442757", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207K00000X", "desc": "Allergy & Immunology", "license": null, "primary": true, "state": null, "taxonomy_group": "193400000X - Single Specialty Group" } ] }, { "addresses": [ { "address_1": "995 S YATES RD STE 3", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-252-0055", "postal_code": "381190882", "state": "TN", "telephone_number": "901-512-8258" }, { "address_1": "PO BOX 381662", "address_purpose": "MAILING", "address_type": "DOM", "city": "GERMANTOWN", "country_code": "US", "country_name": "United States", "fax_number": "901-252-0055", "postal_code": "381831662", "state": "TN", "telephone_number": "901-512-8258" } ], "basic": { "authorized_official_credential": "MD", "authorized_official_first_name": "SAUL", "authorized_official_last_name": "GREENBUAM", "authorized_official_middle_name": "M", "authorized_official_telephone_number": "9015128258", "authorized_official_title_or_position": "Auth Official", "certification_date": "2022-02-02", "enumeration_date": "2021-09-27", "last_updated": "2022-02-02", "organization_name": "ALLERGYONE, PLLC", "organizational_subpart": "NO", "status": "A" }, "created_epoch": "1632759567000", "endpoints": [], "enumeration_type": "NPI-2", "identifiers": [], "last_updated_epoch": "1643831589000", "number": "1508537754", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207RA0201X", "desc": "Internal Medicine, Allergy & Immunology", "license": null, "primary": true, "state": null, "taxonomy_group": "193400000X - Single Specialty Group" } ] }, { "addresses": [ { "address_1": "DEPT. 453 PO BOX 1000", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "828-350-2174", "postal_code": "381480001", "state": "TN", "telephone_number": "828-575-2625" }, { "address_1": "7605 FOREST AVENUE", "address_2": "SUITE 103", "address_purpose": "LOCATION", "address_type": "DOM", "city": "RICHMOND", "country_code": "US", "country_name": "United States", "fax_number": "804-288-2659", "postal_code": "232294936", "state": "VA", "telephone_number": "804-285-4025" } ], "basic": { "certification_date": "2022-05-02", "credential": "M.D", "enumeration_date": "2015-04-29", "first_name": "BALRAJ", "last_name": "BAJAJ", "last_updated": "2022-05-02", "middle_name": "S", "sex": "M", "sole_proprietor": "YES", "status": "A" }, "created_epoch": "1430325357000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "1760869754", "issuer": null, "state": "VA" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "VAC617A", "issuer": "Medicare PTAN", "state": "VA" } ], "last_updated_epoch": "1651494657000", "number": "1760869754", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207K00000X", "desc": "Allergy & Immunology", "license": "0101267271", "primary": true, "state": "VA", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "DEPT. 453 PO BOX 1000", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "828-350-2174", "postal_code": "381480001", "state": "TN", "telephone_number": "828-575-2625" }, { "address_1": "7605 FOREST AVE", "address_2": "SUITE 103", "address_purpose": "LOCATION", "address_type": "DOM", "city": "RICHMOND", "country_code": "US", "country_name": "United States", "fax_number": "804-288-2659", "postal_code": "232294938", "state": "VA", "telephone_number": "804-288-0055" } ], "basic": { "certification_date": "2022-05-19", "credential": "M.D.", "enumeration_date": "2005-12-27", "first_name": "MICHAEL", "last_name": "BLUMBERG", "last_updated": "2022-05-19", "middle_name": "Z", "name_prefix": "Dr.", "sex": "M", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1135708107000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "01", "desc": "Other (non-Medicare)", "identifier": "00Y217A01", "issuer": "MEDICARE PTAN", "state": "VA" }, { "code": "05", "desc": "MEDICAID", "identifier": "1093792517", "issuer": null, "state": "VA" } ], "last_updated_epoch": "1652959129000", "number": "1093792517", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207K00000X", "desc": "Allergy & Immunology", "license": "0101028776", "primary": true, "state": "VA", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "7777 FOREST LN STE B332", "address_purpose": "LOCATION", "address_type": "DOM", "city": "DALLAS", "country_code": "US", "country_name": "United States", "fax_number": "972-566-8837", "postal_code": "752306822", "state": "TX", "telephone_number": "972-566-7788" }, { "address_1": "DEPT. 453 PO BOX 1000", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "828-350-2174", "postal_code": "381480001", "state": "TN", "telephone_number": "828-575-2625" } ], "basic": { "certification_date": "2022-05-03", "credential": "M.D.", "enumeration_date": "2015-04-02", "first_name": "SHEEBA", "last_name": "CHERIAN", "last_updated": "2022-05-03", "middle_name": "K", "sex": "F", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1427998212000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "1417342874", "issuer": null, "state": "TX" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "1E3640", "issuer": "Medicare PTAN", "state": "TX" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "1E3641", "issuer": "Medicare PTAN", "state": "TX" } ], "last_updated_epoch": "1651583852000", "number": "1417342874", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207K00000X", "desc": "Allergy & Immunology", "license": "S4929", "primary": true, "state": "TX", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "1750 MADISON AVE STE 210", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-726-4887", "postal_code": "381046428", "state": "TN", "telephone_number": "901-726-4055" }, { "address_1": "1750 MADISON AVE STE 210", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-726-4887", "postal_code": "381046428", "state": "TN", "telephone_number": "901-726-4055" } ], "basic": { "credential": "M.D.", "enumeration_date": "2006-08-19", "first_name": "STEVE", "last_name": "COLE", "last_updated": "2007-07-08", "name_prefix": "Dr.", "name_suffix": "--", "sex": "M", "sole_proprietor": "YES", "status": "A" }, "created_epoch": "1155991054000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "3025394", "issuer": null, "state": "TN" } ], "last_updated_epoch": "1183947785000", "number": "1952415424", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207KA0200X", "desc": "Allergy & Immunology, Allergy", "license": "MD0000015712", "primary": true, "state": "TN", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "14 MCDOWELL ST", "address_purpose": "LOCATION", "address_type": "DOM", "city": "ASHEVILLE", "country_code": "US", "country_name": "United States", "fax_number": "828-254-9925", "postal_code": "288014104", "state": "NC", "telephone_number": "828-255-3749" }, { "address_1": "DEPT. 453 PO BOX 1000", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "828-350-2174", "postal_code": "381480001", "state": "TN", "telephone_number": "828-575-2625" } ], "basic": { "certification_date": "2023-10-30", "credential": "M.D,", "enumeration_date": "2005-07-20", "first_name": "CHRISTOPHER", "last_name": "COPENHAVER", "last_updated": "2023-10-30", "middle_name": "CHARLES", "sex": "M", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1121879220000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "1659370708", "issuer": null, "state": "NC" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "2073490", "issuer": "MEDICARE PTAN", "state": "NC" } ], "last_updated_epoch": "1698690677000", "number": "1659370708", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207K00000X", "desc": "Allergy & Immunology", "license": "2009-00510", "primary": true, "state": "NC", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "14 MCDOWELL ST", "address_purpose": "LOCATION", "address_type": "DOM", "city": "ASHEVILLE", "country_code": "US", "country_name": "United States", "fax_number": "828-254-9925", "postal_code": "28801", "state": "NC", "telephone_number": "828-255-3749" }, { "address_1": "DEPT. 453, PO BOX 1000", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "828-350-2174", "postal_code": "381480001", "state": "TN", "telephone_number": "828-575-2625" } ], "basic": { "certification_date": "2023-10-30", "credential": "MD", "enumeration_date": "2013-06-05", "first_name": "CATHERINE", "last_name": "CRANFORD", "last_updated": "2023-10-30", "middle_name": "C", "sex": "F", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1370455688000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "1639517279", "issuer": null, "state": "NC" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "NN3151A", "issuer": "Medicare PTAN", "state": "NC" } ], "last_updated_epoch": "1698691370000", "number": "1639517279", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207K00000X", "desc": "Allergy & Immunology", "license": "2018-01907", "primary": true, "state": "NC", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "14 MCDOWELL ST", "address_purpose": "LOCATION", "address_type": "DOM", "city": "ASHEVILLE", "country_code": "US", "country_name": "United States", "fax_number": "828-254-9925", "postal_code": "288014104", "state": "NC", "telephone_number": "828-255-3749" }, { "address_1": "DEPT 453 PO BOX 1000", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "828-350-2174", "postal_code": "381480001", "state": "TN", "telephone_number": "828-575-2625" } ], "basic": { "certification_date": "2022-06-02", "credential": "MD", "enumeration_date": "2005-11-03", "first_name": "WINSTON", "last_name": "ELLISTON", "last_updated": "2022-06-02", "middle_name": "LEON", "sex": "M", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1131032297000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "1366433898", "issuer": null, "state": "NC" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "202157F", "issuer": "MEDICARE PTAN", "state": "NC" } ], "last_updated_epoch": "1654174556000", "number": "1366433898", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207K00000X", "desc": "Allergy & Immunology", "license": "21399", "primary": true, "state": "NC", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "7605 FOREST AVE STE 103", "address_purpose": "LOCATION", "address_type": "DOM", "city": "RICHMOND", "country_code": "US", "country_name": "United States", "fax_number": "804-288-2659", "postal_code": "232294936", "state": "VA", "telephone_number": "804-288-0055" }, { "address_1": "DEPT. 453 PO BOX 1000", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "828-350-2174", "postal_code": "381480001", "state": "TN", "telephone_number": "828-575-2625" } ], "basic": { "certification_date": "2022-05-03", "credential": "M.D.", "enumeration_date": "2016-03-24", "first_name": "WILLIAM", "last_name": "ESCHENBACHER", "last_updated": "2022-05-03", "middle_name": "HARVEY", "name_prefix": "Dr.", "sex": "M", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1458871220000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "1659733947", "issuer": null, "state": "VA" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "VAC572B", "issuer": "Medicare PTAN", "state": "VA" } ], "last_updated_epoch": "1651585845000", "number": "1659733947", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207K00000X", "desc": "Allergy & Immunology", "license": "0101268412", "primary": true, "state": "VA", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "DEPT. 453 PO BOX 1000", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "828-350-2174", "postal_code": "381480001", "state": "TN", "telephone_number": "828-575-2625" }, { "address_1": "553 CEDAR LN STE A", "address_purpose": "LOCATION", "address_type": "DOM", "city": "TEANECK", "country_code": "US", "country_name": "United States", "fax_number": "201-836-0399", "postal_code": "076661712", "state": "NJ", "telephone_number": "201-836-6400" } ], "basic": { "certification_date": "2022-04-28", "credential": "MD", "enumeration_date": "2016-06-07", "first_name": "ELEANOR", "last_name": "FELDMAN", "last_updated": "2022-04-28", "middle_name": "J", "name_prefix": "Dr.", "sex": "F", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1465333016000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "0828084", "issuer": null, "state": "NJ" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "1S5946", "issuer": "Medicare PTAN", "state": "NJ" } ], "last_updated_epoch": "1651173820000", "number": "1861841165", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207K00000X", "desc": "Allergy & Immunology", "license": "25MA11209200", "primary": true, "state": "NJ", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "2615 LAKE DR", "address_2": "SUITE 301", "address_purpose": "LOCATION", "address_type": "DOM", "city": "RALEIGH", "country_code": "US", "country_name": "United States", "fax_number": "919-783-9406", "postal_code": "276076693", "state": "NC", "telephone_number": "919-787-5995" }, { "address_1": "DEPT. 453 PO BOX 1000", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "828-350-2174", "postal_code": "381480001", "state": "TN", "telephone_number": "828-575-2625" } ], "basic": { "certification_date": "2023-10-31", "credential": "M.D.", "enumeration_date": "2005-07-07", "first_name": "VINCENT", "last_name": "FIRRINCIELI", "last_updated": "2023-10-31", "middle_name": "LAWRENCE", "sex": "M", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1120751139000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "1952308801", "issuer": null, "state": "NC" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "NCS118A", "issuer": "Medicare PTAN", "state": "NC" } ], "last_updated_epoch": "1698757293000", "number": "1952308801", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207K00000X", "desc": "Allergy & Immunology", "license": "200300338", "primary": true, "state": "NC", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "101 COSGROVE AVE", "address_2": "SUITE 110", "address_purpose": "LOCATION", "address_type": "DOM", "city": "CHAPEL HILL", "country_code": "US", "country_name": "United States", "postal_code": "275145276", "state": "NC", "telephone_number": "919-929-9612" }, { "address_1": "DEPT 453 PO BOX 1000", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "828-350-2174", "postal_code": "381480001", "state": "TN", "telephone_number": "828-575-2625" } ], "basic": { "certification_date": "2023-10-30", "credential": "M.D.", "enumeration_date": "2007-04-17", "first_name": "DAVID", "last_name": "FITZHUGH", "last_updated": "2023-10-30", "middle_name": "JORDAN", "sex": "M", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1176813881000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "1962627547", "issuer": null, "state": "NC" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "NC7609A", "issuer": "MEDICARE PTAN", "state": "NC" } ], "last_updated_epoch": "1698692703000", "number": "1962627547", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207K00000X", "desc": "Allergy & Immunology", "license": "2009-00998", "primary": true, "state": "NC", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "7001 SIGNAL AVE NE", "address_purpose": "LOCATION", "address_type": "DOM", "city": "ALBUQUERQUE", "country_code": "US", "country_name": "United States", "fax_number": "505-856-2749", "postal_code": "871132453", "state": "NM", "telephone_number": "505-856-2735" }, { "address_1": "DEPT. 453 PO BOX 1000", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "828-350-2174", "postal_code": "381480001", "state": "TN", "telephone_number": "828-575-2625" } ], "basic": { "certification_date": "2023-10-30", "credential": "M.D.", "enumeration_date": "2012-04-05", "first_name": "JACK", "last_name": "GHABLY", "last_updated": "2023-10-30", "middle_name": "GEORGE", "name_prefix": "Dr.", "sex": "M", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1333656280000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "01", "desc": "Other (non-Medicare)", "identifier": "584457AC7E", "issuer": "Medicare PTAN", "state": "NM" }, { "code": "05", "desc": "MEDICAID", "identifier": "82000727", "issuer": null, "state": "NM" } ], "last_updated_epoch": "1698689628000", "number": "1386900116", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207K00000X", "desc": "Allergy & Immunology", "license": "MD2017-0386", "primary": true, "state": "NM", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "9002 N MERIDIAN ST STE 107", "address_purpose": "LOCATION", "address_type": "DOM", "city": "INDIANAPOLIS", "country_code": "US", "country_name": "United States", "fax_number": "317-924-8239", "postal_code": "462605349", "state": "IN", "telephone_number": "317-848-9441" }, { "address_1": "DEPT. 453 PO BOX 1000", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "828-350-2174", "postal_code": "381480001", "state": "TN", "telephone_number": "828-350-2163" } ], "basic": { "certification_date": "2023-02-07", "credential": "M.D.", "enumeration_date": "2005-11-16", "first_name": "PINKUS", "last_name": "GOLDBERG", "last_updated": "2023-02-07", "name_prefix": "Dr.", "sex": "M", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1132169151000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "100145290", "issuer": null, "state": "IN" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "IN1125027", "issuer": "Medicare PTAN", "state": "IN" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "IN1127026", "issuer": "Medicare PTAN", "state": "IN" } ], "last_updated_epoch": "1675791724000", "number": "1740262641", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207K00000X", "desc": "Allergy & Immunology", "license": "01033874A", "primary": true, "state": "IN", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "995 S YATES RD STE 3", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-252-0055", "postal_code": "381190882", "state": "TN", "telephone_number": "901-512-8258" }, { "address_1": "PO BOX 381662", "address_purpose": "MAILING", "address_type": "DOM", "city": "GERMANTOWN", "country_code": "US", "country_name": "United States", "fax_number": "901-252-0055", "postal_code": "381831662", "state": "TN", "telephone_number": "901-512-8258" } ], "basic": { "certification_date": "2022-02-02", "credential": "MD", "enumeration_date": "2014-07-01", "first_name": "SAUL", "last_name": "GREENBAUM", "last_updated": "2022-02-02", "middle_name": "M", "sex": "M", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1404242714000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [], "last_updated_epoch": "1643831437000", "number": "1851707616", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207RA0201X", "desc": "Internal Medicine, Allergy & Immunology", "license": "60765", "primary": true, "state": "TN", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "802 W PARK AVE", "address_2": "STE 213", "address_purpose": "LOCATION", "address_type": "DOM", "city": "OCEAN", "country_code": "US", "country_name": "United States", "fax_number": "732-695-2552", "postal_code": "077128526", "state": "NJ", "telephone_number": "732-695-2555" }, { "address_1": "DEPT. 453 PO BOX 1000", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "828-350-2174", "postal_code": "381480001", "state": "TN", "telephone_number": "828-575-2625" } ], "basic": { "certification_date": "2023-10-30", "credential": "MD", "enumeration_date": "2005-06-08", "first_name": "GARY", "last_name": "GROSS", "last_updated": "2023-10-30", "middle_name": "LANCE", "name_prefix": "Dr.", "sex": "M", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1118281687000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "01", "desc": "Other (non-Medicare)", "identifier": "029133ZKRP", "issuer": "Medicare PTAN", "state": "NJ" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "029133ZVF5", "issuer": "Medicare PTAN", "state": "NJ" }, { "code": "05", "desc": "MEDICAID", "identifier": "3408400", "issuer": null, "state": "NJ" } ], "last_updated_epoch": "1698684454000", "number": "1336143247", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207K00000X", "desc": "Allergy & Immunology", "license": "25MA04805600", "primary": true, "state": "NJ", "taxonomy_group": "" }, { "code": "207K00000X", "desc": "Allergy & Immunology", "license": "MA048056", "primary": false, "state": "NJ", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "4901 N 44TH ST STE 103", "address_purpose": "LOCATION", "address_type": "DOM", "city": "PHOENIX", "country_code": "US", "country_name": "United States", "fax_number": "602-954-0485", "postal_code": "850182782", "state": "AZ", "telephone_number": "602-954-0405" }, { "address_1": "DEPT. 453 PO BOX 1000", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "828-350-2174", "postal_code": "381481934", "state": "TN", "telephone_number": "828-575-2625" } ], "basic": { "certification_date": "2023-04-05", "credential": "MD", "enumeration_date": "2005-08-19", "first_name": "FADIA", "last_name": "HABIB-KHAZEN", "last_updated": "2023-04-05", "middle_name": "K", "sex": "F", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1124470877000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "007204", "issuer": null, "state": "AZ" } ], "last_updated_epoch": "1680718176000", "number": "1063404531", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207K00000X", "desc": "Allergy & Immunology", "license": "22782", "primary": true, "state": "AZ", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "1030 JEFFERSON AVE", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "postal_code": "381042193", "state": "TN", "telephone_number": "901-523-8990" }, { "address_1": "1030 JEFFERSON AVE", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "postal_code": "381042193", "state": "TN", "telephone_number": "901-523-8990" } ], "basic": { "credential": "M.D.", "enumeration_date": "2006-07-12", "first_name": "BRANDON", "last_name": "HILL", "last_updated": "2019-10-18", "sex": "M", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1152715243000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [], "last_updated_epoch": "1571411884000", "number": "1841225257", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207K00000X", "desc": "Allergy & Immunology", "license": "MD00036743", "primary": false, "state": "TN", "taxonomy_group": "" }, { "code": "207R00000X", "desc": "Internal Medicine", "license": "MD0000036743", "primary": true, "state": "TN", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "50 N DUNLAP ST FL 6", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-287-4581", "postal_code": "381032800", "state": "TN", "telephone_number": "901-287-6210" }, { "address_1": "6 TSIENNETO RD STE 300", "address_purpose": "LOCATION", "address_type": "DOM", "city": "DERRY", "country_code": "US", "country_name": "United States", "postal_code": "030381584", "state": "NH", "telephone_number": "603-216-0400" } ], "basic": { "certification_date": "2026-05-12", "credential": "MD", "enumeration_date": "2021-04-04", "first_name": "JOSEPH", "last_name": "HOWARD", "last_updated": "2026-05-12", "middle_name": "MICHAEL", "sex": "M", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1617548286000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [], "last_updated_epoch": "1778607651000", "number": "1770162190", "other_names": [], "practiceLocations": [ { "address_1": "920 MADISON AVE STE 447", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "postal_code": "381033438", "state": "TN", "telephone_number": "901-287-6756" } ], "taxonomies": [ { "code": "207KA0200X", "desc": "Allergy & Immunology, Allergy", "license": "39456", "primary": false, "state": "NH", "taxonomy_group": "" }, { "code": "390200000X", "desc": "Student in an Organized Health Care Education/Training Program", "license": null, "primary": true, "state": null, "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "6263 POPLAR AVE STE 525", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-680-0363", "postal_code": "381194701", "state": "TN", "telephone_number": "901-682-0430" }, { "address_1": "6263 POPLAR AVE STE 525", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-680-0363", "postal_code": "381194701", "state": "TN", "telephone_number": "901-682-0430" } ], "basic": { "authorized_official_credential": "MP", "authorized_official_first_name": "JOE", "authorized_official_last_name": "LEVY", "authorized_official_middle_name": "S", "authorized_official_name_prefix": "Dr.", "authorized_official_name_suffix": "--", "authorized_official_telephone_number": "9016820430", "authorized_official_title_or_position": "Owner", "enumeration_date": "2011-11-14", "last_updated": "2019-04-17", "organization_name": "JOE S LEVY, M.D., P.C.", "organizational_subpart": "NO", "status": "A" }, "created_epoch": "1321304789000", "endpoints": [], "enumeration_type": "NPI-2", "identifiers": [ { "code": "01", "desc": "Other (non-Medicare)", "identifier": "1023001781", "issuer": "Individual NPI", "state": "TN" } ], "last_updated_epoch": "1555523311000", "number": "1932486388", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207K00000X", "desc": "Allergy & Immunology", "license": "05887", "primary": true, "state": "TN", "taxonomy_group": "193400000X - Single Specialty Group" } ] }, { "addresses": [ { "address_1": "48 CREEKVIEW CT", "address_purpose": "LOCATION", "address_type": "DOM", "city": "GREENVILLE", "country_code": "US", "country_name": "United States", "fax_number": "864-458-7463", "postal_code": "296154800", "state": "SC", "telephone_number": "864-458-7431" }, { "address_1": "DEPT 453 PO BOX 1000", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "828-350-2174", "postal_code": "381480001", "state": "TN", "telephone_number": "828-575-2625" } ], "basic": { "certification_date": "2023-10-31", "credential": "MD", "enumeration_date": "2005-10-27", "first_name": "RUDOLPH", "last_name": "JOHNSTONE", "last_updated": "2023-10-31", "middle_name": "GORDON", "name_suffix": "III", "sex": "M", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1130430713000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "136178", "issuer": null, "state": "SC" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "D182976910", "issuer": "MEDICARE PTAN", "state": "SC" } ], "last_updated_epoch": "1698769895000", "number": "1710977962", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207K00000X", "desc": "Allergy & Immunology", "license": "13617", "primary": false, "state": "SC", "taxonomy_group": "" }, { "code": "207K00000X", "desc": "Allergy & Immunology", "license": "MD13617", "primary": true, "state": "SC", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "700 PRIDES XING STE 200", "address_purpose": "MAILING", "address_type": "DOM", "city": "NEWARK", "country_code": "US", "country_name": "United States", "postal_code": "197136109", "state": "DE", "telephone_number": "302-998-0300" }, { "address_1": "700 PRIDES XING STE 200", "address_purpose": "LOCATION", "address_type": "DOM", "city": "NEWARK", "country_code": "US", "country_name": "United States", "postal_code": "197136109", "state": "DE", "telephone_number": "302-998-0300" } ], "basic": { "certification_date": "2023-06-28", "credential": "MD", "enumeration_date": "2017-06-20", "first_name": "MUHAMMAD", "last_name": "KHALID", "last_updated": "2023-06-29", "middle_name": "BILAL", "sex": "M", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1497979805000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [], "last_updated_epoch": "1688048740000", "number": "1760902936", "other_names": [], "practiceLocations": [ { "address_1": "UNIVERSITY OF TENNESSEE 920 MADISON AVE STE 447", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "postal_code": "381630001", "state": "TN", "telephone_number": "901-448-5814" }, { "address_1": "NIH- BUILDING 10, ROOM 12C103", "address_purpose": "LOCATION", "address_type": "DOM", "city": "BETHESDA", "country_code": "US", "country_name": "United States", "postal_code": "208920001", "state": "MD", "telephone_number": "301-761-7685" } ], "taxonomies": [ { "code": "207RA0201X", "desc": "Internal Medicine, Allergy & Immunology", "license": "MD048091", "primary": false, "state": "MD", "taxonomy_group": "" }, { "code": "390200000X", "desc": "Student in an Organized Health Care Education/Training Program", "license": null, "primary": false, "state": null, "taxonomy_group": "" }, { "code": "207K00000X", "desc": "Allergy & Immunology", "license": "C1-0025525", "primary": true, "state": "DE", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "80 ERDMAN WAY STE 315", "address_purpose": "LOCATION", "address_type": "DOM", "city": "LEOMINSTER", "country_code": "US", "country_name": "United States", "postal_code": "014531840", "state": "MA", "telephone_number": "978-537-4805" }, { "address_1": "PO BOX 1000 DEPT 453", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "828-350-2174", "postal_code": "381480001", "state": "TN", "telephone_number": "828-575-2625" } ], "basic": { "certification_date": "2024-05-10", "credential": "MD", "enumeration_date": "2006-12-18", "first_name": "TRACY", "last_name": "KRUZICK", "last_updated": "2024-05-10", "middle_name": "LYNN", "name_prefix": "Dr.", "sex": "F", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1166488796000", "endpoints": [ { "address_1": "10350 E Dakota Ave", "address_type": "DOM", "affiliation": "N", "city": "Denver", "contentOtherDescription": "C-CDA", "contentType": "OTHER", "contentTypeDescription": "Other", "country_code": "US", "country_name": "United States", "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq", "endpointDescription": "Carequality", "endpointType": "SOAP", "endpointTypeDescription": "SOAP URL", "postal_code": "802471314", "state": "CO", "use": "HIE", "useDescription": "Health Information Exchange (HIE)" } ], "enumeration_type": "NPI-1", "identifiers": [ { "code": "01", "desc": "Other (non-Medicare)", "identifier": "029563", "issuer": "Kaiser Commercial Number", "state": "CO" }, { "code": "05", "desc": "MEDICAID", "identifier": "9000200004", "issuer": null, "state": "CO" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "FK0056728", "issuer": "DEA", "state": "CO" } ], "last_updated_epoch": "1715374302000", "number": "1558424812", "other_names": [], "practiceLocations": [ { "address_1": "10350 E DAKOTA AVE", "address_purpose": "LOCATION", "address_type": "DOM", "city": "DENVER", "country_code": "US", "country_name": "United States", "postal_code": "802471314", "state": "CO", "telephone_number": "303-338-4545" } ], "taxonomies": [ { "code": "207K00000X", "desc": "Allergy & Immunology", "license": "238418", "primary": true, "state": "MA", "taxonomy_group": "" }, { "code": "207K00000X", "desc": "Allergy & Immunology", "license": "DR.0046645", "primary": false, "state": "CO", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "920 MADISON AVE STE 447", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "postal_code": "381033438", "state": "TN", "telephone_number": "901-287-6756" }, { "address_1": "920 MADISON AVE STE 447", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "postal_code": "381033438", "state": "TN", "telephone_number": "901-287-6756" } ], "basic": { "certification_date": "2025-06-23", "credential": "MD", "enumeration_date": "2021-04-08", "first_name": "PHUONG", "last_name": "LE", "last_updated": "2025-06-23", "middle_name": "BINH", "name_prefix": "Dr.", "sex": "F", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1617898745000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [], "last_updated_epoch": "1750695344000", "number": "1912587650", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "208000000X", "desc": "Pediatrics", "license": "70920", "primary": false, "state": "TN", "taxonomy_group": "" }, { "code": "390200000X", "desc": "Student in an Organized Health Care Education/Training Program", "license": null, "primary": false, "state": null, "taxonomy_group": "" }, { "code": "207K00000X", "desc": "Allergy & Immunology", "license": "70920", "primary": true, "state": "TN", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "2665 FOX POINTE DR", "address_purpose": "LOCATION", "address_type": "DOM", "city": "COLUMBUS", "country_code": "US", "country_name": "United States", "fax_number": "812-379-9251", "postal_code": "472033222", "state": "IN", "telephone_number": "812-378-3131" }, { "address_1": "DEPT. 453 PO BOX 1000", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "828-350-2174", "postal_code": "381480001", "state": "TN", "telephone_number": "828-575-2625" } ], "basic": { "certification_date": "2022-05-03", "credential": "MD", "enumeration_date": "2006-08-30", "first_name": "FREDERICK", "last_name": "LEICKLY", "last_updated": "2022-05-03", "middle_name": "E", "sex": "M", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1156942904000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "100379150", "issuer": null, "state": "IN" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "IN1125015", "issuer": "Medicare PTAN", "state": "IN" } ], "last_updated_epoch": "1651599181000", "number": "1679682710", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207K00000X", "desc": "Allergy & Immunology", "license": "01042436A", "primary": true, "state": "IN", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "5575 POPLAR AVE", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-680-0363", "postal_code": "381193863", "state": "TN", "telephone_number": "901-682-0430" }, { "address_1": "5575 POPLAR AVE", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-680-0363", "postal_code": "381193863", "state": "TN", "telephone_number": "901-682-0430" } ], "basic": { "credential": "M.D.", "enumeration_date": "2005-08-29", "first_name": "JOE", "last_name": "LEVY", "last_updated": "2016-02-22", "middle_name": "S", "name_prefix": "Dr.", "name_suffix": "--", "sex": "M", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1125345194000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "01", "desc": "Other (non-Medicare)", "identifier": "030000450", "issuer": "Railroad Medicare", "state": "TN" } ], "last_updated_epoch": "1456172025000", "number": "1023001781", "other_names": [ { "code": "2", "credential": "MD", "first_name": "JOE", "last_name": "LEVY", "middle_name": "SIMON", "prefix": "Dr.", "suffix": "--", "type": "Professional Name" } ], "practiceLocations": [], "taxonomies": [ { "code": "207K00000X", "desc": "Allergy & Immunology", "license": "MD0000005887", "primary": true, "state": "TN", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "51 N DUNLAP ST", "address_2": "SUITE 400", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-266-6488", "postal_code": "381054625", "state": "TN", "telephone_number": "901-287-7337" }, { "address_1": "850 POPLAR AVE BLDG 2", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "postal_code": "381054607", "state": "TN" } ], "basic": { "certification_date": "2025-01-28", "credential": "M.D.", "enumeration_date": "2006-07-21", "first_name": "JAY", "last_name": "LIEBERMAN", "last_updated": "2025-01-28", "middle_name": "ADAM", "name_prefix": "Dr.", "sex": "M", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1153518613000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "1528562", "issuer": null, "state": "TN" } ], "last_updated_epoch": "1738098341000", "number": "1407877004", "other_names": [], "practiceLocations": [ { "address_1": "262 DANNY THOMAS PL", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "postal_code": "381053678", "state": "TN", "telephone_number": "901-595-3300" } ], "taxonomies": [ { "code": "207KA0200X", "desc": "Allergy & Immunology, Allergy", "license": "48645", "primary": false, "state": "TN", "taxonomy_group": "" }, { "code": "207K00000X", "desc": "Allergy & Immunology", "license": "254120-1", "primary": false, "state": "NY", "taxonomy_group": "" }, { "code": "207R00000X", "desc": "Internal Medicine", "license": "2006015608", "primary": false, "state": "MO", "taxonomy_group": "" }, { "code": "207K00000X", "desc": "Allergy & Immunology", "license": "48645", "primary": true, "state": "TN", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "6401 POPLAR AVE STE 300", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "855-656-7325", "postal_code": "381194810", "state": "TN", "telephone_number": "901-757-6100" }, { "address_1": "9800 SHELBYVILLE RD STE 220", "address_purpose": "MAILING", "address_type": "DOM", "city": "LOUISVILLE", "country_code": "US", "country_name": "United States", "fax_number": "502-429-6157", "postal_code": "402232992", "state": "KY", "telephone_number": "502-429-8585" } ], "basic": { "certification_date": "2021-05-26", "credential": "MD", "enumeration_date": "2006-07-06", "first_name": "PHILLIP", "last_name": "LIEBERMAN", "last_updated": "2021-05-26", "middle_name": "L", "sex": "M", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1152168664000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [], "last_updated_epoch": "1622036112000", "number": "1629009717", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207K00000X", "desc": "Allergy & Immunology", "license": "MD00005630", "primary": true, "state": "TN", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "1100 6TH ST STE 203", "address_purpose": "LOCATION", "address_type": "DOM", "city": "CORALVILLE", "country_code": "US", "country_name": "United States", "fax_number": "319-339-3871", "postal_code": "522411757", "state": "IA", "telephone_number": "319-339-3850" }, { "address_1": "DEPT. 453 PO BOX 1000", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "828-350-2174", "postal_code": "381480001", "state": "TN", "telephone_number": "828-575-2625" } ], "basic": { "certification_date": "2022-05-03", "credential": "MD", "enumeration_date": "2005-10-18", "first_name": "MARTA", "last_name": "LITTLE", "last_updated": "2022-05-03", "middle_name": "MARIE", "name_prefix": "Dr.", "sex": "F", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1129660449000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "1962491373", "issuer": null, "state": "IA" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "IB3947001", "issuer": "Medicare PTAN", "state": "IA" } ], "last_updated_epoch": "1651588143000", "number": "1962491373", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207K00000X", "desc": "Allergy & Immunology", "license": "MD-24377", "primary": true, "state": "IA", "taxonomy_group": "" }, { "code": "207RA0201X", "desc": "Internal Medicine, Allergy & Immunology", "license": "24377", "primary": false, "state": "IA", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "5625 POPLAR AVE", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-763-4332", "postal_code": "381193816", "state": "TN", "telephone_number": "901-761-1220" }, { "address_1": "5625 POPLAR AVE", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-763-4332", "postal_code": "381193816", "state": "TN", "telephone_number": "901-761-1220" } ], "basic": { "credential": "APRN,BC", "enumeration_date": "2006-07-06", "first_name": "TERRYE", "last_name": "MASTIN", "last_updated": "2012-02-14", "name_prefix": "--", "name_suffix": "--", "sex": "F", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1152189403000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [], "last_updated_epoch": "1329254300000", "number": "1730110693", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207K00000X", "desc": "Allergy & Immunology", "license": "APN6208", "primary": false, "state": "TN", "taxonomy_group": "" }, { "code": "364SA2200X", "desc": "Clinical Nurse Specialist, Adult Health", "license": "TN6208", "primary": true, "state": "TN", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "2615 LAKE DR", "address_2": "SUITE 301", "address_purpose": "LOCATION", "address_type": "DOM", "city": "RALEIGH", "country_code": "US", "country_name": "United States", "fax_number": "919-783-9406", "postal_code": "276076693", "state": "NC", "telephone_number": "919-787-5995" }, { "address_1": "DEPT. 453 PO BOX 1000", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "828-350-2174", "postal_code": "381480001", "state": "TN", "telephone_number": "828-575-2625" } ], "basic": { "certification_date": "2023-10-31", "credential": "M.D.", "enumeration_date": "2008-05-08", "first_name": "LAURIE", "last_name": "MCWILLIAMS", "last_updated": "2023-10-31", "middle_name": "MARIE", "name_prefix": "Dr.", "sex": "F", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1210281958000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "1699942714", "issuer": null, "state": "NC" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "NCG147C", "issuer": "Medicare PTAN", "state": "NC" } ], "last_updated_epoch": "1698757403000", "number": "1699942714", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207K00000X", "desc": "Allergy & Immunology", "license": "2009-00618", "primary": true, "state": "NC", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "51 N DUNLAP ST", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-266-6488", "postal_code": "381054625", "state": "TN", "telephone_number": "901-287-7337" }, { "address_1": "850 POPLAR AVE BLDG 2", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "postal_code": "381054607", "state": "TN" } ], "basic": { "certification_date": "2020-11-18", "credential": "MD", "enumeration_date": "2006-04-21", "first_name": "CHRISTIE", "last_name": "MICHAEL", "last_updated": "2020-11-18", "middle_name": "F", "name_prefix": "Dr.", "sex": "F", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1145649724000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "03636241", "issuer": null, "state": "MS" }, { "code": "05", "desc": "MEDICAID", "identifier": "158607001", "issuer": null, "state": "AR" }, { "code": "05", "desc": "MEDICAID", "identifier": "Q002691", "issuer": null, "state": "TN" } ], "last_updated_epoch": "1605716224000", "number": "1467418186", "other_names": [], "practiceLocations": [ { "address_1": "100 N HUMPHREYS BLVD", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-266-6488", "postal_code": "381202146", "state": "TN", "telephone_number": "901-287-7337" } ], "taxonomies": [ { "code": "2080P0201X", "desc": "Pediatrics, Pediatric Allergy/Immunology", "license": "32039", "primary": true, "state": "TN", "taxonomy_group": "" }, { "code": "207RA0201X", "desc": "Internal Medicine, Allergy & Immunology", "license": "32039", "primary": false, "state": "TN", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "708 HILL COUNTRY DR", "address_2": "STE 400", "address_purpose": "LOCATION", "address_type": "DOM", "city": "KERRVILLE", "country_code": "US", "country_name": "United States", "fax_number": "830-896-1440", "postal_code": "780286071", "state": "TX", "telephone_number": "830-896-1433" }, { "address_1": "DEPT. 453 PO BOX 1000", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "828-350-2174", "postal_code": "381480001", "state": "TN", "telephone_number": "828-575-2625" } ], "basic": { "certification_date": "2023-10-31", "credential": "MD", "enumeration_date": "2005-06-21", "first_name": "DALE", "last_name": "MOHAR", "last_updated": "2023-10-31", "middle_name": "E", "sex": "M", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1119379261000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "01", "desc": "Other (non-Medicare)", "identifier": "1A1591", "issuer": "Medicare PTAN", "state": "TX" } ], "last_updated_epoch": "1698778546000", "number": "1194721696", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207K00000X", "desc": "Allergy & Immunology", "license": "J0136", "primary": true, "state": "TX", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "511 PARK HILL DRIVE", "address_purpose": "LOCATION", "address_type": "DOM", "city": "FREDERICKSBURG", "country_code": "US", "country_name": "United States", "fax_number": "540-372-6920", "postal_code": "224013377", "state": "VA", "telephone_number": "540-371-5660" }, { "address_1": "DEPT. 453 PO BOX 1000", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "828-350-2174", "postal_code": "381480001", "state": "TN", "telephone_number": "828-575-2625" } ], "basic": { "certification_date": "2023-10-31", "credential": "M.D.", "enumeration_date": "2006-06-12", "first_name": "JONATHAN", "last_name": "MOZENA", "last_updated": "2023-10-31", "middle_name": "DANIEL", "sex": "M", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1150131980000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "01", "desc": "Other (non-Medicare)", "identifier": "014630A38", "issuer": "MEDICARE PTAN", "state": "VA" }, { "code": "05", "desc": "MEDICAID", "identifier": "1093757163", "issuer": null, "state": "VA" } ], "last_updated_epoch": "1698779467000", "number": "1093757163", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207K00000X", "desc": "Allergy & Immunology", "license": "0101239028", "primary": true, "state": "VA", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "166 PASADENA DRIVE SUITE 150", "address_purpose": "LOCATION", "address_type": "DOM", "city": "LEXINGTON", "country_code": "US", "country_name": "United States", "fax_number": "859-277-1237", "postal_code": "405032938", "state": "KY", "telephone_number": "859-276-1452" }, { "address_1": "DEPT. 453 PO BOX 1000", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "828-350-2174", "postal_code": "381480001", "state": "TN", "telephone_number": "828-575-2625" } ], "basic": { "certification_date": "2023-10-30", "credential": "MD, PhD", "enumeration_date": "2006-04-14", "first_name": "TRACIE", "last_name": "OVERBECK", "last_updated": "2023-10-30", "middle_name": "L", "name_prefix": "Dr.", "sex": "F", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1145045917000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "64086788", "issuer": null, "state": "KY" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "K092670", "issuer": "MEDICARE PTAN", "state": "KY" } ], "last_updated_epoch": "1698683429000", "number": "1881658805", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207K00000X", "desc": "Allergy & Immunology", "license": "40012", "primary": true, "state": "KY", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "9800 SHELBYVILLE RD STE 220", "address_purpose": "MAILING", "address_type": "DOM", "city": "LOUISVILLE", "country_code": "US", "country_name": "United States", "postal_code": "402232992", "state": "KY", "telephone_number": "800-999-1249" }, { "address_1": "6401 POPLAR AVE STE 300", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "postal_code": "381194810", "state": "TN", "telephone_number": "800-999-1249" } ], "basic": { "certification_date": "2025-04-01", "credential": "DO", "enumeration_date": "2016-06-06", "first_name": "REENA", "last_name": "PATEL", "last_updated": "2025-04-01", "sex": "F", "sole_proprietor": "YES", "status": "A" }, "created_epoch": "1465235069000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [], "last_updated_epoch": "1743546566000", "number": "1669821187", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207K00000X", "desc": "Allergy & Immunology", "license": "6091", "primary": true, "state": "TN", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "6401 POPLAR AVE STE 300", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "postal_code": "381194810", "state": "TN", "telephone_number": "901-757-6100" }, { "address_1": "9800 SHELBYVILLE RD STE 220", "address_purpose": "MAILING", "address_type": "DOM", "city": "LOUISVILLE", "country_code": "US", "country_name": "United States", "fax_number": "855-656-7325", "postal_code": "402232992", "state": "KY", "telephone_number": "502-429-8585" } ], "basic": { "certification_date": "2022-10-18", "credential": "M.D.", "enumeration_date": "2016-04-19", "first_name": "VENUSA", "last_name": "PHOMAKAY", "last_updated": "2022-10-18", "sex": "F", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1461110448000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [], "last_updated_epoch": "1666120082000", "number": "1578917233", "other_names": [], "practiceLocations": [ { "address_1": "311 E MONROE AVE", "address_purpose": "LOCATION", "address_type": "DOM", "city": "JONESBORO", "country_code": "US", "country_name": "United States", "fax_number": "855-656-7325", "postal_code": "724012923", "state": "AR", "telephone_number": "800-999-1249" } ], "taxonomies": [ { "code": "207K00000X", "desc": "Allergy & Immunology", "license": "0000061383", "primary": true, "state": "TN", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "9800 SHELBYVILLE RD", "address_2": "STE 220", "address_purpose": "MAILING", "address_type": "DOM", "city": "LOUISVILLE", "country_code": "US", "country_name": "United States", "fax_number": "855-656-7325", "postal_code": "402232992", "state": "KY", "telephone_number": "502-429-8585" }, { "address_1": "6401 POPLAR AVE STE 300", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "855-656-7325", "postal_code": "381194810", "state": "TN", "telephone_number": "901-757-6100" } ], "basic": { "certification_date": "2022-06-30", "credential": "D.O.", "enumeration_date": "2016-04-18", "first_name": "AMY", "last_name": "RAGSDALE", "last_updated": "2022-06-30", "middle_name": "ELIZABETH", "sex": "F", "sole_proprietor": "YES", "status": "A" }, "created_epoch": "1461029007000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [], "last_updated_epoch": "1656598521000", "number": "1023462868", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207K00000X", "desc": "Allergy & Immunology", "license": "E-14133", "primary": false, "state": "AR", "taxonomy_group": "" }, { "code": "207K00000X", "desc": "Allergy & Immunology", "license": "3808", "primary": true, "state": "TN", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "1514 JEFFERSON HWY", "address_purpose": "MAILING", "address_type": "DOM", "city": "NEW ORLEANS", "country_code": "US", "country_name": "United States", "postal_code": "701212429", "state": "LA", "telephone_number": "504-842-4000" }, { "address_1": "10310 THE GROVE BLVD", "address_purpose": "LOCATION", "address_type": "DOM", "city": "BATON ROUGE", "country_code": "US", "country_name": "United States", "fax_number": "225-761-5259", "postal_code": "70836", "state": "LA", "telephone_number": "225-761-5272" } ], "basic": { "credential": "M.D.", "enumeration_date": "2006-05-23", "first_name": "JO", "last_name": "REED", "last_updated": "2019-08-01", "middle_name": "SHANI", "name_prefix": "Dr.", "sex": "F", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1148427524000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "Q017941", "issuer": null, "state": "TN" } ], "last_updated_epoch": "1564686830000", "number": "1861447310", "other_names": [], "practiceLocations": [ { "address_1": "2861 BROAD AVE", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "postal_code": "381122903", "state": "TN", "telephone_number": "901-701-2520" }, { "address_1": "2861 BROAD AVE", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "postal_code": "381122903", "state": "TN", "telephone_number": "901-701-2520" } ], "taxonomies": [ { "code": "207K00000X", "desc": "Allergy & Immunology", "license": "19828", "primary": false, "state": "MS", "taxonomy_group": "" }, { "code": "2080P0201X", "desc": "Pediatrics, Pediatric Allergy/Immunology", "license": "19828", "primary": false, "state": "MS", "taxonomy_group": "" }, { "code": "207K00000X", "desc": "Allergy & Immunology", "license": "320359", "primary": true, "state": "LA", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "40 S MAIN ST STE 1300", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "256-547-9755", "postal_code": "381035513", "state": "TN", "telephone_number": "866-949-0108" }, { "address_1": "420 20TH ST N STE 2200", "address_purpose": "LOCATION", "address_type": "DOM", "city": "BIRMINGHAM", "country_code": "US", "country_name": "United States", "postal_code": "352033261", "state": "AL", "telephone_number": "866-949-0108" } ], "basic": { "authorized_official_credential": "MD", "authorized_official_first_name": "ANDREW", "authorized_official_last_name": "BROWN", "authorized_official_middle_name": "M.", "authorized_official_name_prefix": "Dr.", "authorized_official_name_suffix": "--", "authorized_official_telephone_number": "2565474971", "authorized_official_title_or_position": "Owner", "certification_date": "2021-08-27", "enumeration_date": "2007-06-01", "last_updated": "2021-08-27", "organization_name": "RIVER CITY ALLERGY & MEDICAL PA", "organizational_subpart": "NO", "status": "A" }, "created_epoch": "1180729502000", "endpoints": [], "enumeration_type": "NPI-2", "identifiers": [ { "code": "01", "desc": "Other (non-Medicare)", "identifier": "000000740", "issuer": "PTAN", "state": "AL" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "040015339", "issuer": "RAILROAD RETIREMENT MEDIC", "state": "GA" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "051000740", "issuer": "Blue Cross Blue Shield", "state": "AL" } ], "last_updated_epoch": "1630094706000", "number": "1790987725", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207K00000X", "desc": "Allergy & Immunology", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207Y00000X", "desc": "Otolaryngology", "license": null, "primary": true, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" } ] }, { "addresses": [ { "address_1": "1202 E BUTLER RD", "address_purpose": "LOCATION", "address_type": "DOM", "city": "GREENVILLE", "country_code": "US", "country_name": "United States", "fax_number": "864-672-2654", "postal_code": "296075910", "state": "SC", "telephone_number": "864-627-3800" }, { "address_1": "1202 E BUTLER RD", "address_purpose": "MAILING", "address_type": "DOM", "city": "GREENVILLE", "country_code": "US", "country_name": "United States", "fax_number": "864-672-2654", "postal_code": "296075910", "state": "SC", "telephone_number": "864-627-3800" } ], "basic": { "certification_date": "2025-06-15", "credential": "DO", "enumeration_date": "2020-04-05", "first_name": "HEEMA", "last_name": "SHAH", "last_updated": "2025-06-15", "middle_name": "KUMUD", "name_prefix": "Dr.", "sex": "F", "sole_proprietor": "YES", "status": "A" }, "created_epoch": "1586108873000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [], "last_updated_epoch": "1750024727000", "number": "1770112435", "other_names": [], "practiceLocations": [ { "address_1": "848 ADAMS AVE", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "postal_code": "381032816", "state": "TN", "telephone_number": "901-287-7337" } ], "taxonomies": [ { "code": "208000000X", "desc": "Pediatrics", "license": "5115", "primary": false, "state": "TN", "taxonomy_group": "" }, { "code": "207K00000X", "desc": "Allergy & Immunology", "license": "93608", "primary": true, "state": "SC", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "7777 FOREST LN", "address_2": "SUITE B-332", "address_purpose": "LOCATION", "address_type": "DOM", "city": "DALLAS", "country_code": "US", "country_name": "United States", "fax_number": "972-566-8837", "postal_code": "752302571", "state": "TX", "telephone_number": "972-566-7788" }, { "address_1": "DEPT. 453 PO BOX 1000", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "828-350-2174", "postal_code": "381480001", "state": "TN", "telephone_number": "828-575-2625" } ], "basic": { "certification_date": "2022-05-03", "credential": "MD", "enumeration_date": "2005-09-01", "first_name": "ROBERT", "last_name": "SUGERMAN", "last_updated": "2022-05-03", "middle_name": "W", "sex": "M", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1125597162000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "1598759862", "issuer": null, "state": "TX" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "1C3545", "issuer": "Medicare PTAN", "state": "TX" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "397464ZM3L", "issuer": "MEDICARE PTAN", "state": "TX" } ], "last_updated_epoch": "1651609677000", "number": "1598759862", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207K00000X", "desc": "Allergy & Immunology", "license": "J0295", "primary": true, "state": "TX", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "1458 W POPLAR AVE", "address_2": "STE 205", "address_purpose": "LOCATION", "address_type": "DOM", "city": "COLLIERVILLE", "country_code": "US", "country_name": "United States", "fax_number": "901-244-2021", "postal_code": "380170631", "state": "TN", "telephone_number": "901-335-8966" }, { "address_1": "1458 W POPLAR AVE", "address_2": "STE 205", "address_purpose": "MAILING", "address_type": "DOM", "city": "COLLIERVILLE", "country_code": "US", "country_name": "United States", "fax_number": "901-244-2021", "postal_code": "380170631", "state": "TN", "telephone_number": "901-335-8966" } ], "basic": { "certification_date": "2021-11-17", "credential": "MD", "enumeration_date": "2006-01-25", "first_name": "MICHAEL", "last_name": "TANKERSLEY", "last_updated": "2021-11-17", "middle_name": "S.", "name_prefix": "Dr.", "sex": "M", "sole_proprietor": "YES", "status": "A" }, "created_epoch": "1138201834000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [], "last_updated_epoch": "1637182318000", "number": "1114997814", "other_names": [], "practiceLocations": [ { "address_1": "95 S MAIN ST APT 102", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-244-2021", "postal_code": "381032944", "state": "TN", "telephone_number": "901-335-8966" } ], "taxonomies": [ { "code": "207K00000X", "desc": "Allergy & Immunology", "license": "23880", "primary": false, "state": "MS", "taxonomy_group": "" }, { "code": "207KA0200X", "desc": "Allergy & Immunology, Allergy", "license": "26872", "primary": false, "state": "TN", "taxonomy_group": "" }, { "code": "207KI0005X", "desc": "Allergy & Immunology, Clinical & Laboratory Immunology", "license": "26872", "primary": false, "state": "TN", "taxonomy_group": "" }, { "code": "207N00000X", "desc": "Dermatology", "license": "26872", "primary": false, "state": "TN", "taxonomy_group": "" }, { "code": "207NP0225X", "desc": "Dermatology, Pediatric Dermatology", "license": "26872", "primary": false, "state": "TN", "taxonomy_group": "" }, { "code": "207RA0201X", "desc": "Internal Medicine, Allergy & Immunology", "license": "26872", "primary": false, "state": "TN", "taxonomy_group": "" }, { "code": "207RI0001X", "desc": "Internal Medicine, Clinical & Laboratory Immunology", "license": "26872", "primary": false, "state": "TN", "taxonomy_group": "" }, { "code": "207Y00000X", "desc": "Otolaryngology", "license": "26872", "primary": false, "state": "TN", "taxonomy_group": "" }, { "code": "207YX0602X", "desc": "Otolaryngology, Otolaryngic Allergy", "license": "26872", "primary": false, "state": "TN", "taxonomy_group": "" }, { "code": "2080P0201X", "desc": "Pediatrics, Pediatric Allergy/Immunology", "license": "26872", "primary": false, "state": "TN", "taxonomy_group": "" }, { "code": "207K00000X", "desc": "Allergy & Immunology", "license": "26872", "primary": true, "state": "TN", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "1458 W POPLAR AVE STE 205", "address_purpose": "MAILING", "address_type": "DOM", "city": "COLLIERVILLE", "country_code": "US", "country_name": "United States", "fax_number": "901-244-2021", "postal_code": "380170631", "state": "TN", "telephone_number": "901-335-8966" }, { "address_1": "1458 W POPLAR AVE STE 205", "address_purpose": "LOCATION", "address_type": "DOM", "city": "COLLIERVILLE", "country_code": "US", "country_name": "United States", "fax_number": "901-244-2021", "postal_code": "380170631", "state": "TN", "telephone_number": "901-335-8966" } ], "basic": { "authorized_official_credential": "MD", "authorized_official_first_name": "MICHAEL", "authorized_official_last_name": "TANKERSLEY", "authorized_official_name_prefix": "Dr.", "authorized_official_telephone_number": "9013358966", "authorized_official_title_or_position": "Owner/Founder", "certification_date": "2022-03-18", "enumeration_date": "2017-08-29", "last_updated": "2022-03-18", "organization_name": "THE TANKERSLEY CLINIC, PLLC", "organizational_subpart": "NO", "status": "A" }, "created_epoch": "1504056511000", "endpoints": [], "enumeration_type": "NPI-2", "identifiers": [], "last_updated_epoch": "1647634016000", "number": "1588181580", "other_names": [], "practiceLocations": [ { "address_1": "95 S MAIN ST APT 102", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-244-2021", "postal_code": "381032944", "state": "TN", "telephone_number": "901-335-8966" } ], "taxonomies": [ { "code": "207KI0005X", "desc": "Allergy & Immunology, Clinical & Laboratory Immunology", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207N00000X", "desc": "Dermatology", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207NP0225X", "desc": "Dermatology, Pediatric Dermatology", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207RA0201X", "desc": "Internal Medicine, Allergy & Immunology", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207KA0200X", "desc": "Allergy & Immunology, Allergy", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207RI0001X", "desc": "Internal Medicine, Clinical & Laboratory Immunology", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207Y00000X", "desc": "Otolaryngology", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207YX0602X", "desc": "Otolaryngology, Otolaryngic Allergy", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "2080I0007X", "desc": "Pediatrics, Clinical & Laboratory Immunology", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "2080P0201X", "desc": "Pediatrics, Pediatric Allergy/Immunology", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207K00000X", "desc": "Allergy & Immunology", "license": null, "primary": true, "state": null, "taxonomy_group": "193400000X - Single Specialty Group" } ] }, { "addresses": [ { "address_1": "DEPT. 453 PO BOX 1000", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "828-350-2174", "postal_code": "381480001", "state": "TN", "telephone_number": "828-575-2625" }, { "address_1": "1651 GALISTEO ST STE 8", "address_purpose": "LOCATION", "address_type": "DOM", "city": "SANTA FE", "country_code": "US", "country_name": "United States", "fax_number": "505-983-1265", "postal_code": "875054752", "state": "NM", "telephone_number": "505-820-9870" } ], "basic": { "certification_date": "2022-04-27", "credential": "M. D.", "enumeration_date": "2005-10-27", "first_name": "JANNA", "last_name": "TUCK", "last_updated": "2022-04-27", "middle_name": "MARIE", "name_prefix": "Dr.", "sex": "F", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1130420392000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "55771718", "issuer": null, "state": "NM" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "637008AU6T", "issuer": "Medicare PTAN", "state": "NM" } ], "last_updated_epoch": "1651082776000", "number": "1346230646", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207K00000X", "desc": "Allergy & Immunology", "license": "108098", "primary": false, "state": "MO", "taxonomy_group": "" }, { "code": "207K00000X", "desc": "Allergy & Immunology", "license": "MD2017-0858", "primary": true, "state": "NM", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "14 MCDOWELL ST", "address_purpose": "LOCATION", "address_type": "DOM", "city": "ASHEVILLE", "country_code": "US", "country_name": "United States", "fax_number": "828-254-9925", "postal_code": "288014104", "state": "NC", "telephone_number": "828-255-3749" }, { "address_1": "DEPT. 453 PO BOX 1000", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "828-350-2174", "postal_code": "381480001", "state": "TN", "telephone_number": "828-575-2625" } ], "basic": { "certification_date": "2023-10-30", "credential": "MD", "enumeration_date": "2005-11-03", "first_name": "JOHN", "last_name": "VAN WYE", "last_updated": "2023-10-30", "middle_name": "EDWARD", "sex": "M", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1131032721000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "1790776235", "issuer": null, "state": "NC" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "2157485E", "issuer": "MEDICARE PTAN", "state": "NC" } ], "last_updated_epoch": "1698690770000", "number": "1790776235", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207K00000X", "desc": "Allergy & Immunology", "license": "40012", "primary": true, "state": "NC", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "P.O. BOX 262", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "615-936-5862", "postal_code": "381010262", "state": "TN", "telephone_number": "615-936-2727" }, { "address_1": "2611 WEST END AVENUE", "address_2": "SUITE 210", "address_purpose": "LOCATION", "address_type": "DOM", "city": "NASHVILLE", "country_code": "US", "country_name": "United States", "fax_number": "615-936-5862", "postal_code": "37203", "state": "TN", "telephone_number": "615-936-2727" } ], "basic": { "authorized_official_first_name": "ANGELA", "authorized_official_last_name": "BARKSDALE", "authorized_official_name_prefix": "Mrs.", "authorized_official_name_suffix": "--", "authorized_official_telephone_number": "6159362727", "authorized_official_title_or_position": "Manager Physician Billing Services", "enumeration_date": "2008-01-31", "last_updated": "2009-09-09", "organization_name": "VANDERBILT ASTHMA SINUS AND ALLERGY PROGRAM, LLC", "organizational_subpart": "NO", "status": "A" }, "created_epoch": "1201790423000", "endpoints": [], "enumeration_type": "NPI-2", "identifiers": [ { "code": "01", "desc": "Other (non-Medicare)", "identifier": "=========", "issuer": "Tax ID", "state": "TN" }, { "code": "05", "desc": "MEDICAID", "identifier": "Pending", "issuer": null, "state": "TN" } ], "last_updated_epoch": "1252523892000", "number": "1134306244", "other_names": [ { "code": "3", "organization_name": "VANDERBILT ASTHMA SINUS AND ALLERGY PROGRAM, LLC", "type": "Doing Business As" } ], "practiceLocations": [], "taxonomies": [ { "code": "207K00000X", "desc": "Allergy & Immunology", "license": null, "primary": true, "state": null, "taxonomy_group": "193400000X - Single Specialty Group" } ] }, { "addresses": [ { "address_1": "1755 KIRBY PKWY", "address_2": "SUITE 100", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-758-2276", "postal_code": "381208300", "state": "TN", "telephone_number": "901-758-0112" }, { "address_1": "1755 KIRBY PKWY", "address_2": "SUITE 100", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-758-2276", "postal_code": "381208300", "state": "TN", "telephone_number": "901-758-0112" } ], "basic": { "authorized_official_credential": "M.D.", "authorized_official_first_name": "WILLIAM", "authorized_official_last_name": "TAYLOR", "authorized_official_middle_name": "W", "authorized_official_name_prefix": "--", "authorized_official_name_suffix": "Jr.", "authorized_official_telephone_number": "9017580112", "authorized_official_title_or_position": "Owner", "enumeration_date": "2006-06-19", "last_updated": "2010-02-02", "organization_name": "W.W. TAYLOR, JR, M.D., P.C.", "organizational_subpart": "NO", "status": "A" }, "created_epoch": "1150754309000", "endpoints": [], "enumeration_type": "NPI-2", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "3154957", "issuer": null, "state": "TN" } ], "last_updated_epoch": "1265139830000", "number": "1942245121", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207KA0200X", "desc": "Allergy & Immunology, Allergy", "license": "6297", "primary": true, "state": "TN", "taxonomy_group": "193400000X - Single Specialty Group" } ] }, { "addresses": [ { "address_1": "4646 POPLAR AVE STE 302", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "905-552-3902", "postal_code": "381174433", "state": "TN", "telephone_number": "901-930-7397" }, { "address_1": "4646 POPLAR AVE STE 302", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-552-3902", "postal_code": "381174433", "state": "TN", "telephone_number": "901-930-7397" } ], "basic": { "certification_date": "2022-10-19", "credential": "MD", "enumeration_date": "2006-09-25", "first_name": "RICHARD", "last_name": "WANDERMAN", "last_updated": "2022-10-19", "middle_name": "G", "name_prefix": "Dr.", "sex": "M", "sole_proprietor": "YES", "status": "A" }, "created_epoch": "1159216035000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "3194814", "issuer": null, "state": "TN" } ], "last_updated_epoch": "1666209101000", "number": "1184724312", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207KA0200X", "desc": "Allergy & Immunology, Allergy", "license": "22468", "primary": false, "state": "TN", "taxonomy_group": "" }, { "code": "207Q00000X", "desc": "Family Medicine", "license": "22468", "primary": false, "state": "TN", "taxonomy_group": "" }, { "code": "2080A0000X", "desc": "Pediatrics, Adolescent Medicine", "license": "22468", "primary": true, "state": "TN", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "7001 SIGNAL AVE NE", "address_purpose": "LOCATION", "address_type": "DOM", "city": "ALBUQUERQUE", "country_code": "US", "country_name": "United States", "fax_number": "505-856-2749", "postal_code": "871132453", "state": "NM", "telephone_number": "505-856-2735" }, { "address_1": "DEPT. 453 PO BOX 1000", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "828-350-2174", "postal_code": "381480001", "state": "TN", "telephone_number": "828-575-2625" } ], "basic": { "certification_date": "2022-04-28", "credential": "MD", "enumeration_date": "2007-02-06", "first_name": "SHANZE", "last_name": "WANG", "last_updated": "2022-04-28", "sex": "M", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1170773438000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "98905244", "issuer": null, "state": "NM" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "NMAAA1693", "issuer": "MEDICARE PTAN", "state": "NM" } ], "last_updated_epoch": "1651157391000", "number": "1922147958", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207K00000X", "desc": "Allergy & Immunology", "license": "MD2011-0579", "primary": true, "state": "NM", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "511 PARK HILL DR", "address_purpose": "LOCATION", "address_type": "DOM", "city": "FREDERICKSBURG", "country_code": "US", "country_name": "United States", "fax_number": "540-372-6920", "postal_code": "224013377", "state": "VA", "telephone_number": "540-371-5660" }, { "address_1": "DEPT. 453 PO BOX 1000", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "828-350-2174", "postal_code": "381480001", "state": "TN", "telephone_number": "828-575-2625" } ], "basic": { "certification_date": "2022-06-06", "credential": "M. D.", "enumeration_date": "2005-10-27", "first_name": "MARK", "last_name": "WENGER", "last_updated": "2022-06-06", "middle_name": "A", "sex": "M", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1130425431000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "01", "desc": "Other (non-Medicare)", "identifier": "006254A38", "issuer": "MEDICARE PTAN", "state": "VA" }, { "code": "05", "desc": "MEDICAID", "identifier": "1336139666", "issuer": null, "state": "VA" } ], "last_updated_epoch": "1654541239000", "number": "1336139666", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207K00000X", "desc": "Allergy & Immunology", "license": "0101059064", "primary": true, "state": "VA", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "66 N PAULINE ST", "address_2": "SUITE 206", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-448-8015", "postal_code": "381055105", "state": "TN", "telephone_number": "901-448-7642" }, { "address_1": "1910 NONCONNAH BLVD", "address_2": "SUITE 120", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-448-6657", "postal_code": "381322113", "state": "TN", "telephone_number": "901-448-2300" } ], "basic": { "credential": "MD", "enumeration_date": "2006-04-21", "first_name": "TAI", "last_name": "YOO", "last_updated": "2007-07-09", "middle_name": "JUNE", "name_prefix": "Dr.", "name_suffix": "--", "sex": "M", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1145648511000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "3000214", "issuer": null, "state": "TN" } ], "last_updated_epoch": "1183957886000", "number": "1366408072", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207RA0201X", "desc": "Internal Medicine, Allergy & Immunology", "license": "12899", "primary": true, "state": "TN", "taxonomy_group": "" } ] } ] }