{ "result_count": 92, "results": [ { "addresses": [ { "address_1": "6255 W SUNSET BLVD FL 21", "address_purpose": "MAILING", "address_type": "DOM", "city": "LOS ANGELES", "country_code": "US", "country_name": "United States", "fax_number": "323-467-7119", "postal_code": "900287422", "state": "CA", "telephone_number": "323-860-5200" }, { "address_1": "880 MADISON AVE", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-545-6424", "postal_code": "381033409", "state": "TN", "telephone_number": "901-545-6969" } ], "basic": { "certification_date": "2025-09-17", "credential": "M.D", "enumeration_date": "2009-04-10", "first_name": "TINA", "last_name": "AGBAOSI", "last_updated": "2025-09-17", "middle_name": "A", "name_prefix": "Dr.", "name_suffix": "--", "sex": "F", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1239404870000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "01", "desc": "Other (non-Medicare)", "identifier": "103i115728", "issuer": "MEDICARE TN", "state": "TN" }, { "code": "05", "desc": "MEDICAID", "identifier": "1525608", "issuer": null, "state": "TN" } ], "last_updated_epoch": "1758125703000", "number": "1740423417", "other_names": [], "practiceLocations": [ { "address_1": "4299 ELVIS PRESLEY BLVD STE 3", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "833-973-5742", "postal_code": "381166435", "state": "TN", "telephone_number": "601-368-3450" } ], "taxonomies": [ { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "47524", "primary": true, "state": "TN", "taxonomy_group": "" }, { "code": "207R00000X", "desc": "Internal Medicine", "license": "57.015230", "primary": false, "state": "OH", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "6255 W SUNSET BLVD FL 21", "address_purpose": "MAILING", "address_type": "DOM", "city": "LOS ANGELES", "country_code": "US", "country_name": "United States", "postal_code": "900287422", "state": "CA", "telephone_number": "323-860-5200" }, { "address_1": "4299 ELVIS PRESLEY BLVD STE 3", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "855-345-0929", "postal_code": "381166435", "state": "TN", "telephone_number": "601-368-3450" } ], "basic": { "authorized_official_first_name": "LYLE", "authorized_official_last_name": "HONIG MOJICA", "authorized_official_telephone_number": "3238605200", "authorized_official_title_or_position": "CFO", "certification_date": "2025-04-03", "enumeration_date": "2025-04-03", "last_updated": "2025-04-03", "organization_name": "AIDS HEALTHCARE FOUNDATION", "organizational_subpart": "NO", "status": "A" }, "created_epoch": "1743689402000", "endpoints": [], "enumeration_type": "NPI-2", "identifiers": [], "last_updated_epoch": "1743689402000", "number": "1790589208", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207R00000X", "desc": "Internal Medicine", "license": null, "primary": true, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" } ] }, { "addresses": [ { "address_1": "1211 UNION AVE STE 330", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "postal_code": "381046655", "state": "TN" }, { "address_1": "1325 EASTMORELAND AVE STE 360", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-516-8550", "postal_code": "381047514", "state": "TN", "telephone_number": "901-516-8714" } ], "basic": { "certification_date": "2026-02-05", "credential": "MD", "enumeration_date": "2019-07-24", "first_name": "ELMARIE", "last_name": "ALEXANDER", "last_updated": "2026-02-05", "sex": "F", "sole_proprietor": "YES", "status": "A" }, "created_epoch": "1564020640000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [], "last_updated_epoch": "1770313444000", "number": "1942854336", "other_names": [], "practiceLocations": [ { "address_1": "1211 UNION AVE STE 200", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-526-9014", "postal_code": "381046654", "state": "TN", "telephone_number": "901-525-0278" } ], "taxonomies": [ { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "74416", "primary": true, "state": "TN", "taxonomy_group": "" }, { "code": "390200000X", "desc": "Student in an Organized Health Care Education/Training Program", "license": null, "primary": false, "state": null, "taxonomy_group": "193400000X - Single Specialty Group" } ] }, { "addresses": [ { "address_1": "PO BOX 100 DEPT#394", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "941-404-1760", "postal_code": "381480001", "state": "TN", "telephone_number": "941-300-4440" }, { "address_1": "18360 NW 47TH AVE", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MIAMI GARDENS", "country_code": "US", "country_name": "United States", "fax_number": "888-285-1741", "postal_code": "330552934", "state": "FL", "telephone_number": "786-800-5631" } ], "basic": { "certification_date": "2026-04-16", "credential": "M.D.", "enumeration_date": "2007-06-01", "first_name": "JESSICA", "last_name": "ALTAMIRANO", "last_updated": "2026-04-16", "middle_name": "ALEXANDRA", "name_prefix": "Dr.", "sex": "F", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1180699214000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "024341300", "issuer": null, "state": "FL" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "14P0W", "issuer": "BCBS Provider #", "state": "FL" } ], "last_updated_epoch": "1776331444000", "number": "1518169721", "other_names": [], "practiceLocations": [ { "address_1": "427 WASHINGTON AVE", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MIAMI BEACH", "country_code": "US", "country_name": "United States", "postal_code": "331396617", "state": "FL", "telephone_number": "305-514-0813" }, { "address_1": "4350 FOWLER ST STE 2", "address_purpose": "LOCATION", "address_type": "DOM", "city": "FORT MYERS", "country_code": "US", "country_name": "United States", "fax_number": "855-576-5116", "postal_code": "339012600", "state": "FL", "telephone_number": "239-837-8187" } ], "taxonomies": [ { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "ME113540", "primary": true, "state": "FL", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "1325 EASTMORELAND AVE", "address_2": "SUITE 370", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-387-5153", "postal_code": "381043519", "state": "TN", "telephone_number": "901-758-7888" }, { "address_1": "1211 UNION AVE STE 330", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "postal_code": "381046655", "state": "TN" } ], "basic": { "certification_date": "2025-04-14", "credential": "MD", "enumeration_date": "2008-07-15", "first_name": "CHINELO", "last_name": "ANIMALU", "last_updated": "2025-04-14", "middle_name": "NGOZI", "sex": "F", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1216161665000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "05087052", "issuer": null, "state": "MS" }, { "code": "05", "desc": "MEDICAID", "identifier": "210841001", "issuer": null, "state": "AR" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "5448780", "issuer": "BCBS", "state": "TN" }, { "code": "05", "desc": "MEDICAID", "identifier": "Q014407", "issuer": null, "state": "TN" } ], "last_updated_epoch": "1744637686000", "number": "1881858165", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "50126", "primary": true, "state": "TN", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "350 N HUMPHREYS BLVD", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "postal_code": "381202177", "state": "TN", "telephone_number": "901-227-0084" }, { "address_1": "350 N HUMPHREYS BLVD", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "postal_code": "381202177", "state": "TN", "telephone_number": "901-227-0084" } ], "basic": { "certification_date": "2025-11-12", "credential": "PharmD", "enumeration_date": "2025-11-12", "first_name": "KRISTA", "last_name": "BACHERT", "last_updated": "2025-11-12", "middle_name": "COVAL", "sex": "F", "sole_proprietor": "YES", "status": "A" }, "created_epoch": "1762975809000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [], "last_updated_epoch": "1762975809000", "number": "1538029673", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "1835I0206X", "desc": "Pharmacist, Infectious Diseases", "license": "10941", "primary": true, "state": "TN", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "965 RIDGE LAKE BLVD", "address_2": "STE 103", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-227-8591", "postal_code": "381209446", "state": "TN", "telephone_number": "901-227-3255" }, { "address_1": "1200 N STATE ST", "address_2": "SUITE 500", "address_purpose": "LOCATION", "address_type": "DOM", "city": "JACKSON", "country_code": "US", "country_name": "United States", "fax_number": "601-714-3415", "postal_code": "392022000", "state": "MS", "telephone_number": "601-352-2273" } ], "basic": { "credential": "MD", "enumeration_date": "2007-05-18", "first_name": "BRET", "last_name": "BARRETT", "last_updated": "2018-03-29", "middle_name": "J", "name_prefix": "Dr.", "sex": "M", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1179529917000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "06903314", "issuer": null, "state": "MS" } ], "last_updated_epoch": "1522354927000", "number": "1265640577", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "20210", "primary": true, "state": "MS", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "P O BOX 1000 DEPT 0364", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-767-3884", "postal_code": "381480364", "state": "TN", "telephone_number": "901-767-3123" }, { "address_1": "6019 WALNUT GROVE RD", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-767-3884", "postal_code": "38120", "state": "TN", "telephone_number": "901-767-3123" } ], "basic": { "credential": "md", "enumeration_date": "2006-05-31", "first_name": "MITCHELL", "last_name": "BEATUS", "last_updated": "2011-08-31", "middle_name": "DREW", "name_prefix": "Dr.", "name_suffix": "--", "sex": "M", "sole_proprietor": "YES", "status": "A" }, "created_epoch": "1149115125000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "00121243", "issuer": null, "state": "MS" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "110105498", "issuer": "Railroad Medicare", "state": "GA" }, { "code": "05", "desc": "MEDICAID", "identifier": "139226001", "issuer": null, "state": "AR" }, { "code": "05", "desc": "MEDICAID", "identifier": "3090636", "issuer": null, "state": "TN" } ], "last_updated_epoch": "1314808397000", "number": "1255378238", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "md26466", "primary": true, "state": "TN", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "PO BOX 100 DEPT#394", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "941-404-1760", "postal_code": "381480001", "state": "TN", "telephone_number": "941-300-4440" }, { "address_1": "315 SE 14TH ST", "address_purpose": "LOCATION", "address_type": "DOM", "city": "FORT LAUDERDALE", "country_code": "US", "country_name": "United States", "fax_number": "855-643-6201", "postal_code": "333161929", "state": "FL", "telephone_number": "954-701-6920" } ], "basic": { "certification_date": "2024-02-13", "credential": "M.D.", "enumeration_date": "2006-11-29", "first_name": "PETER", "last_name": "BERKEY", "last_updated": "2024-02-13", "middle_name": "B", "name_prefix": "Dr.", "sex": "M", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1164846752000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "01", "desc": "Other (non-Medicare)", "identifier": "0000924", "issuer": "GHI", "state": null }, { "code": "05", "desc": "MEDICAID", "identifier": "01091143", "issuer": null, "state": "NY" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "0915351", "issuer": "Aetna and US Healthcare", "state": null }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "09727P", "issuer": "HIP", "state": null }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "0D1595", "issuer": "Healthnet", "state": null }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "3401982", "issuer": "United Healthcare", "state": null }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "440003595", "issuer": "RR Medicare", "state": null }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "WS365", "issuer": "Oxford", "state": null } ], "last_updated_epoch": "1707860048000", "number": "1881761245", "other_names": [], "practiceLocations": [ { "address_1": "4101 NW 3RD CT STE 9", "address_purpose": "LOCATION", "address_type": "DOM", "city": "PLANTATION", "country_code": "US", "country_name": "United States", "postal_code": "333172830", "state": "FL", "telephone_number": "954-701-6911" }, { "address_1": "1224 DEL PRADO BLVD S STE A", "address_purpose": "LOCATION", "address_type": "DOM", "city": "CAPE CORAL", "country_code": "US", "country_name": "United States", "postal_code": "339903670", "state": "FL", "telephone_number": "239-945-9401" }, { "address_1": "14243 TAMIAMI TRL", "address_purpose": "LOCATION", "address_type": "DOM", "city": "NORTH PORT", "country_code": "US", "country_name": "United States", "postal_code": "342872215", "state": "FL", "telephone_number": "941-888-2144" } ], "taxonomies": [ { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "ME132416", "primary": true, "state": "FL", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "2574 FRAYSER BLVD", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "postal_code": "381275829", "state": "TN", "telephone_number": "901-271-9500" }, { "address_1": "4095 AMERICAN WAY", "address_2": "SUITE 1", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "postal_code": "381188339", "state": "TN", "telephone_number": "901-271-9500" } ], "basic": { "certification_date": "2024-08-07", "credential": "MD", "enumeration_date": "2006-10-25", "first_name": "PETER", "last_name": "BLATZ", "last_updated": "2024-08-07", "middle_name": "JAMES", "name_prefix": "Dr.", "sex": "M", "sole_proprietor": "YES", "status": "A" }, "created_epoch": "1161820042000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [], "last_updated_epoch": "1723041069000", "number": "1134204662", "other_names": [], "practiceLocations": [ { "address_1": "880 MADISON AVE", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "postal_code": "381033409", "state": "TN", "telephone_number": "901-545-7100" } ], "taxonomies": [ { "code": "207R00000X", "desc": "Internal Medicine", "license": "0106407A", "primary": false, "state": "IN", "taxonomy_group": "" }, { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "23646", "primary": false, "state": "MS", "taxonomy_group": "" }, { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "54902", "primary": true, "state": "TN", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "6029 WALNUT GROVE RD STE 209", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-821-9987", "postal_code": "381202112", "state": "TN", "telephone_number": "901-681-0778" }, { "address_1": "6027 WALNUT GROVE RD STE 312", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-821-9987", "postal_code": "381202128", "state": "TN", "telephone_number": "901-681-0778" } ], "basic": { "certification_date": "2023-01-24", "credential": "M.D.", "enumeration_date": "2014-07-08", "first_name": "INDERJEET", "last_name": "BRAR", "last_updated": "2023-01-24", "middle_name": "SINGH", "name_prefix": "Mr.", "sex": "M", "sole_proprietor": "YES", "status": "A" }, "created_epoch": "1404844324000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "004055792", "issuer": null, "state": "MS" }, { "code": "05", "desc": "MEDICAID", "identifier": "Q049056", "issuer": null, "state": "TN" } ], "last_updated_epoch": "1674574488000", "number": "1558777821", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "58539", "primary": true, "state": "TN", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "877 JEFFERSON AVE", "address_2": "ATTN: PROVIDER ENROLLMENT", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "postal_code": "381032807", "state": "TN", "telephone_number": "901-545-7302" }, { "address_1": "880 MADISON AVE", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-545-7177", "postal_code": "381033409", "state": "TN", "telephone_number": "901-545-6969" } ], "basic": { "credential": "MD", "enumeration_date": "2006-04-26", "first_name": "SUSAN", "last_name": "BREWER", "last_updated": "2015-10-08", "middle_name": "CROUCH", "name_prefix": "Dr.", "name_suffix": "--", "sex": "F", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1146090641000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [], "last_updated_epoch": "1444321631000", "number": "1164489092", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207R00000X", "desc": "Internal Medicine", "license": "24312", "primary": false, "state": "TN", "taxonomy_group": "" }, { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "24312", "primary": true, "state": "TN", "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": "2006-05-01", "first_name": "JEFFREY", "last_name": "BRINT", "last_updated": "2007-07-08", "middle_name": "MARK", "name_prefix": "Dr.", "name_suffix": "--", "sex": "M", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1146490100000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "3072099", "issuer": null, "state": "TN" } ], "last_updated_epoch": "1183947785000", "number": "1679530877", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "19514", "primary": true, "state": "TN", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "1200 N STATE ST", "address_2": "SUITE 500", "address_purpose": "LOCATION", "address_type": "DOM", "city": "JACKSON", "country_code": "US", "country_name": "United States", "fax_number": "601-714-3414", "postal_code": "392022000", "state": "MS", "telephone_number": "601-352-2273" }, { "address_1": "965 RIDGE LAKE BLVD STE 103", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-227-8591", "postal_code": "381209446", "state": "TN", "telephone_number": "901-227-3255" } ], "basic": { "credential": "M.D.", "enumeration_date": "2006-11-13", "first_name": "MICHAEL", "last_name": "BYERS", "last_updated": "2018-02-15", "middle_name": "R", "sex": "M", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1163454293000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "00116198", "issuer": null, "state": "MS" } ], "last_updated_epoch": "1518727300000", "number": "1346311982", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "11343", "primary": true, "state": "MS", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "DEPT 394 PO BOX 1000", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "941-404-1760", "postal_code": "38148", "state": "TN", "telephone_number": "941-300-4440" }, { "address_1": "3012 E COMMERCIAL BLVD", "address_purpose": "LOCATION", "address_type": "DOM", "city": "FORT LAUDERDALE", "country_code": "US", "country_name": "United States", "fax_number": "941-776-9993", "postal_code": "333084356", "state": "FL", "telephone_number": "954-776-9992" } ], "basic": { "authorized_official_first_name": "RISHI", "authorized_official_last_name": "PATEL", "authorized_official_middle_name": "B", "authorized_official_telephone_number": "9413004440", "authorized_official_title_or_position": "President & CEO", "certification_date": "2026-02-11", "enumeration_date": "2026-02-11", "last_updated": "2026-02-11", "organization_name": "CAN COMMUNITY HEALTH INC.", "organizational_subpart": "NO", "status": "A" }, "created_epoch": "1770822602000", "endpoints": [], "enumeration_type": "NPI-2", "identifiers": [], "last_updated_epoch": "1770822602000", "number": "1992657134", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "101YM0800X", "desc": "Counselor, Mental Health", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "1041C0700X", "desc": "Social Worker, Clinical", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207R00000X", "desc": "Internal Medicine", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "2084P0800X", "desc": "Psychiatry & Neurology, Psychiatry", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "363LF0000X", "desc": "Nurse Practitioner, Family", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "363LP0808X", "desc": "Nurse Practitioner, Psych/Mental Health", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "363LW0102X", "desc": "Nurse Practitioner, Women's Health", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": null, "primary": true, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" } ] }, { "addresses": [ { "address_1": "2105 N NEBRASKA AVE", "address_purpose": "LOCATION", "address_type": "DOM", "city": "TAMPA", "country_code": "US", "country_name": "United States", "fax_number": "844-722-0028", "postal_code": "336022558", "state": "FL", "telephone_number": "813-769-7207" }, { "address_1": "PO BOX 1000 DEPT 394", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "941-404-1760", "postal_code": "381480001", "state": "TN", "telephone_number": "941-300-4440" } ], "basic": { "authorized_official_first_name": "RISHI", "authorized_official_last_name": "PATEL", "authorized_official_middle_name": "B", "authorized_official_telephone_number": "9413004440", "authorized_official_title_or_position": "President & CEO", "certification_date": "2024-01-30", "enumeration_date": "2021-08-27", "last_updated": "2024-01-30", "organization_name": "CAN COMMUNITY HEALTH INC.", "organizational_subpart": "NO", "status": "A" }, "created_epoch": "1630077000000", "endpoints": [], "enumeration_type": "NPI-2", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "057256040", "issuer": null, "state": "FL" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "21725", "issuer": "BCBS FL Group #", "state": "FL" } ], "last_updated_epoch": "1706646698000", "number": "1669149563", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "101YM0800X", "desc": "Counselor, Mental Health", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207Q00000X", "desc": "Family Medicine", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207R00000X", "desc": "Internal Medicine", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "363LF0000X", "desc": "Nurse Practitioner, Family", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "363LP0808X", "desc": "Nurse Practitioner, Psych/Mental Health", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": null, "primary": true, "state": null, "taxonomy_group": "193400000X - Single Specialty Group" } ] }, { "addresses": [ { "address_1": "DEPT 394 PO BOX 1000", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "941-404-1760", "postal_code": "38148", "state": "TN", "telephone_number": "941-300-4440" }, { "address_1": "4211 CEDAR SPRINGS RD STE 200A", "address_purpose": "LOCATION", "address_type": "DOM", "city": "DALLAS", "country_code": "US", "country_name": "United States", "fax_number": "877-673-3560", "postal_code": "752192600", "state": "TX", "telephone_number": "945-351-0450" } ], "basic": { "authorized_official_first_name": "RISHI", "authorized_official_last_name": "PATEL", "authorized_official_middle_name": "B", "authorized_official_telephone_number": "9413004440", "authorized_official_title_or_position": "President & CEO", "certification_date": "2026-02-11", "enumeration_date": "2026-02-11", "last_updated": "2026-02-11", "organization_name": "CAN COMMUNITY HEALTH INC.", "organizational_subpart": "NO", "status": "A" }, "created_epoch": "1770823203000", "endpoints": [], "enumeration_type": "NPI-2", "identifiers": [], "last_updated_epoch": "1770823203000", "number": "1255283404", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207R00000X", "desc": "Internal Medicine", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "363LF0000X", "desc": "Nurse Practitioner, Family", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "363LW0102X", "desc": "Nurse Practitioner, Women's Health", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": null, "primary": true, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" } ] }, { "addresses": [ { "address_1": "201 N DIXIE HWY", "address_purpose": "LOCATION", "address_type": "DOM", "city": "LAKE WORTH", "country_code": "US", "country_name": "United States", "fax_number": "800-755-8631", "postal_code": "334603079", "state": "FL", "telephone_number": "561-867-9991" }, { "address_1": "PO BOX 1000 DEPT 394", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "941-404-1760", "postal_code": "381480001", "state": "TN", "telephone_number": "941-300-4440" } ], "basic": { "authorized_official_first_name": "RISHI", "authorized_official_last_name": "PATEL", "authorized_official_middle_name": "B", "authorized_official_telephone_number": "9413004440", "authorized_official_title_or_position": "President & CEO", "certification_date": "2024-01-30", "enumeration_date": "2021-06-07", "last_updated": "2024-01-30", "organization_name": "CAN COMMUNITY HEALTH, INC.", "organizational_subpart": "NO", "status": "A" }, "created_epoch": "1623076074000", "endpoints": [], "enumeration_type": "NPI-2", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "057256036", "issuer": null, "state": "FL" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "21725", "issuer": "FL BCBS Group #", "state": "FL" } ], "last_updated_epoch": "1706646472000", "number": "1679140925", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "363LP0808X", "desc": "Nurse Practitioner, Psych/Mental Health", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "1041C0700X", "desc": "Social Worker, Clinical", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207Q00000X", "desc": "Family Medicine", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207R00000X", "desc": "Internal Medicine", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": null, "primary": true, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" } ] }, { "addresses": [ { "address_1": "PO BOX 1000 DEPT 394", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "941-404-1760", "postal_code": "381480001", "state": "TN", "telephone_number": "941-300-4440" }, { "address_1": "1820 E SAHARA AVE STE 201", "address_purpose": "LOCATION", "address_type": "DOM", "city": "LAS VEGAS", "country_code": "US", "country_name": "United States", "fax_number": "702-979-6227", "postal_code": "891043721", "state": "NV", "telephone_number": "702-979-1111" } ], "basic": { "authorized_official_first_name": "RISHI", "authorized_official_last_name": "PATEL", "authorized_official_middle_name": "B", "authorized_official_telephone_number": "9413004440", "authorized_official_title_or_position": "President & CEO", "certification_date": "2024-11-25", "enumeration_date": "2024-11-25", "last_updated": "2024-11-25", "organization_name": "CAN COMMUNITY HEALTH, INC.", "organizational_subpart": "NO", "status": "A" }, "created_epoch": "1732573503000", "endpoints": [], "enumeration_type": "NPI-2", "identifiers": [], "last_updated_epoch": "1732573503000", "number": "1700602679", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207Q00000X", "desc": "Family Medicine", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207R00000X", "desc": "Internal Medicine", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": null, "primary": true, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" } ] }, { "addresses": [ { "address_1": "3251 3RD AVE N RM 125", "address_purpose": "LOCATION", "address_type": "DOM", "city": "ST PETERSBURG", "country_code": "US", "country_name": "United States", "fax_number": "855-896-5258", "postal_code": "337138549", "state": "FL", "telephone_number": "727-498-4969" }, { "address_1": "PO BOX 1000 DEPT 394", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "941-404-1760", "postal_code": "381482558", "state": "TN", "telephone_number": "941-300-4440" } ], "basic": { "authorized_official_first_name": "RISHI", "authorized_official_last_name": "PATEL", "authorized_official_middle_name": "B", "authorized_official_telephone_number": "9413004440", "authorized_official_title_or_position": "President & CEO", "certification_date": "2024-01-30", "enumeration_date": "2021-06-07", "last_updated": "2024-01-30", "organization_name": "CAN COMMUNITY HEALTH, INC.", "organizational_subpart": "NO", "status": "A" }, "created_epoch": "1623073069000", "endpoints": [], "enumeration_type": "NPI-2", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "057256023", "issuer": null, "state": "FL" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "21725", "issuer": "FL BCBS Group #", "state": "FL" } ], "last_updated_epoch": "1706639169000", "number": "1851968192", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "101YM0800X", "desc": "Counselor, Mental Health", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207Q00000X", "desc": "Family Medicine", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207R00000X", "desc": "Internal Medicine", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "363AM0700X", "desc": "Physician Assistant, Medical", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "363LF0000X", "desc": "Nurse Practitioner, Family", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "363LP0808X", "desc": "Nurse Practitioner, Psych/Mental Health", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": null, "primary": true, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" } ] }, { "addresses": [ { "address_1": "1435 DUNN AVE STE 101", "address_purpose": "LOCATION", "address_type": "DOM", "city": "DAYTONA BEACH", "country_code": "US", "country_name": "United States", "fax_number": "877-242-5455", "postal_code": "321141434", "state": "FL", "telephone_number": "386-274-7651" }, { "address_1": "PO BOX 1000 DEPT 394", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "941-404-1760", "postal_code": "381482558", "state": "TN", "telephone_number": "941-300-4440" } ], "basic": { "authorized_official_first_name": "RISHI", "authorized_official_last_name": "PATEL", "authorized_official_middle_name": "B", "authorized_official_telephone_number": "9413004440", "authorized_official_title_or_position": "President & CEO", "certification_date": "2024-01-30", "enumeration_date": "2021-06-06", "last_updated": "2024-01-30", "organization_name": "CAN COMMUNITY HEALTH, INC.", "organizational_subpart": "NO", "status": "A" }, "created_epoch": "1623019683000", "endpoints": [], "enumeration_type": "NPI-2", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "057256016", "issuer": null, "state": "FL" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "21725", "issuer": "BCBS FL Group #", "state": "FL" } ], "last_updated_epoch": "1706639796000", "number": "1598332801", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "1041C0700X", "desc": "Social Worker, Clinical", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "1223G0001X", "desc": "Dentist, General Practice", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207Q00000X", "desc": "Family Medicine", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207R00000X", "desc": "Internal Medicine", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "363LP0808X", "desc": "Nurse Practitioner, Psych/Mental Health", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "363LW0102X", "desc": "Nurse Practitioner, Women's Health", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": null, "primary": true, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" } ] }, { "addresses": [ { "address_1": "4615 PHILIPS HWY STE 3", "address_purpose": "LOCATION", "address_type": "DOM", "city": "JACKSONVILLE", "country_code": "US", "country_name": "United States", "fax_number": "855-299-0710", "postal_code": "322079541", "state": "FL", "telephone_number": "904-508-0710" }, { "address_1": "PO BOX 1000 DEPT 394", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "941-404-1760", "postal_code": "381481926", "state": "TN", "telephone_number": "941-300-4440" } ], "basic": { "authorized_official_first_name": "RISHI", "authorized_official_last_name": "PATEL", "authorized_official_middle_name": "B", "authorized_official_telephone_number": "9413004440", "authorized_official_title_or_position": "President & CEO", "certification_date": "2024-01-30", "enumeration_date": "2021-06-06", "last_updated": "2024-01-30", "organization_name": "CAN COMMUNITY HEALTH, INC.", "organizational_subpart": "NO", "status": "A" }, "created_epoch": "1623032525000", "endpoints": [], "enumeration_type": "NPI-2", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "057256020", "issuer": null, "state": "FL" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "21725", "issuer": "FL BCBS Group #", "state": null } ], "last_updated_epoch": "1706640235000", "number": "1336716653", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "363LF0000X", "desc": "Nurse Practitioner, Family", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "363LP0808X", "desc": "Nurse Practitioner, Psych/Mental Health", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "363LW0102X", "desc": "Nurse Practitioner, Women's Health", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207R00000X", "desc": "Internal Medicine", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "101YM0800X", "desc": "Counselor, Mental Health", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "1041C0700X", "desc": "Social Worker, Clinical", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207Q00000X", "desc": "Family Medicine", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": null, "primary": true, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" } ] }, { "addresses": [ { "address_1": "PO BOX 1000 DEPT 394", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "941-404-1760", "postal_code": "381481926", "state": "TN", "telephone_number": "941-300-4440" }, { "address_1": "14243 TAMIAMI TRL", "address_purpose": "LOCATION", "address_type": "DOM", "city": "NORTH PORT", "country_code": "US", "country_name": "United States", "fax_number": "888-213-0604", "postal_code": "342872215", "state": "FL", "telephone_number": "941-888-2144" } ], "basic": { "authorized_official_first_name": "RISHI", "authorized_official_last_name": "PATEL", "authorized_official_middle_name": "B", "authorized_official_telephone_number": "9413004440", "authorized_official_title_or_position": "President & CEO", "certification_date": "2024-01-30", "enumeration_date": "2021-06-07", "last_updated": "2024-01-30", "organization_name": "CAN COMMUNITY HEALTH, INC.", "organizational_subpart": "NO", "status": "A" }, "created_epoch": "1623071960000", "endpoints": [], "enumeration_type": "NPI-2", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "057256015", "issuer": null, "state": "FL" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "21725", "issuer": "BCBS FL Group #", "state": "FL" } ], "last_updated_epoch": "1706644480000", "number": "1508433830", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207Q00000X", "desc": "Family Medicine", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207R00000X", "desc": "Internal Medicine", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": null, "primary": true, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" } ] }, { "addresses": [ { "address_1": "427 WASHINGTON AVE", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MIAMI BEACH", "country_code": "US", "country_name": "United States", "fax_number": "855-235-4811", "postal_code": "331396617", "state": "FL", "telephone_number": "305-514-0813" }, { "address_1": "PO BOX 1000 DEPT 394", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "941-404-1760", "postal_code": "381481926", "state": "TN", "telephone_number": "941-300-4440" } ], "basic": { "authorized_official_first_name": "RISHI", "authorized_official_last_name": "PATEL", "authorized_official_middle_name": "B", "authorized_official_telephone_number": "9413004440", "authorized_official_title_or_position": "President & CEO", "certification_date": "2024-01-30", "enumeration_date": "2021-06-07", "last_updated": "2024-01-30", "organization_name": "CAN COMMUNITY HEALTH, INC.", "organizational_subpart": "NO", "status": "A" }, "created_epoch": "1623072726000", "endpoints": [], "enumeration_type": "NPI-2", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "057256005", "issuer": null, "state": "FL" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "21725", "issuer": "FL BCBS Group #", "state": null } ], "last_updated_epoch": "1706645098000", "number": "1043887383", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207R00000X", "desc": "Internal Medicine", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "363LP0808X", "desc": "Nurse Practitioner, Psych/Mental Health", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "1041C0700X", "desc": "Social Worker, Clinical", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": null, "primary": true, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" } ] }, { "addresses": [ { "address_1": "8390 N PALAFOX ST", "address_purpose": "LOCATION", "address_type": "DOM", "city": "PENSACOLA", "country_code": "US", "country_name": "United States", "fax_number": "877-266-7170", "postal_code": "325343735", "state": "FL", "telephone_number": "850-988-5245" }, { "address_1": "PO BOX 1000 DEPT 394", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "941-404-1760", "postal_code": "381481926", "state": "TN", "telephone_number": "941-300-4440" } ], "basic": { "authorized_official_first_name": "RISHI", "authorized_official_last_name": "PATEL", "authorized_official_middle_name": "B", "authorized_official_telephone_number": "9413004440", "authorized_official_title_or_position": "President & CEO", "certification_date": "2024-01-30", "enumeration_date": "2021-06-07", "last_updated": "2024-01-30", "organization_name": "CAN COMMUNITY HEALTH, INC.", "organizational_subpart": "NO", "status": "A" }, "created_epoch": "1623075249000", "endpoints": [], "enumeration_type": "NPI-2", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "057256039", "issuer": null, "state": "FL" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "21725", "issuer": "FL BCB Group #", "state": "FL" } ], "last_updated_epoch": "1706646194000", "number": "1437726775", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "101YM0800X", "desc": "Counselor, Mental Health", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "1041C0700X", "desc": "Social Worker, Clinical", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207R00000X", "desc": "Internal Medicine", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "363AM0700X", "desc": "Physician Assistant, Medical", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "363LP0808X", "desc": "Nurse Practitioner, Psych/Mental Health", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": null, "primary": true, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" } ] }, { "addresses": [ { "address_1": "1911 HAMPTON ST", "address_purpose": "LOCATION", "address_type": "DOM", "city": "COLUMBIA", "country_code": "US", "country_name": "United States", "fax_number": "877-826-1561", "postal_code": "292013535", "state": "SC", "telephone_number": "803-849-8430" }, { "address_1": "PO BOX 1000 DEPT 394", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "941-404-1760", "postal_code": "381480001", "state": "TN", "telephone_number": "941-300-4440" } ], "basic": { "authorized_official_first_name": "RISHI", "authorized_official_last_name": "PATEL", "authorized_official_middle_name": "B", "authorized_official_telephone_number": "9413004440", "authorized_official_title_or_position": "President & CEO", "certification_date": "2024-01-30", "enumeration_date": "2021-06-07", "last_updated": "2024-01-30", "organization_name": "CAN COMMUNITY HEALTH, INC.", "organizational_subpart": "NO", "status": "A" }, "created_epoch": "1623086442000", "endpoints": [], "enumeration_type": "NPI-2", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "GP7940", "issuer": null, "state": "SC" } ], "last_updated_epoch": "1706648884000", "number": "1164099461", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207Q00000X", "desc": "Family Medicine", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207R00000X", "desc": "Internal Medicine", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "363LA2200X", "desc": "Nurse Practitioner, Adult Health", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": null, "primary": true, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" } ] }, { "addresses": [ { "address_1": "295 E MAIN ST STE 315", "address_purpose": "LOCATION", "address_type": "DOM", "city": "DENVILLE", "country_code": "US", "country_name": "United States", "fax_number": "844-922-2777", "postal_code": "078342642", "state": "NJ", "telephone_number": "973-370-3130" }, { "address_1": "PO BOX 1000 DEPT 394", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "941-404-1760", "postal_code": "381480001", "state": "TN", "telephone_number": "941-300-4440" } ], "basic": { "authorized_official_first_name": "RISHI", "authorized_official_last_name": "PATEL", "authorized_official_middle_name": "B", "authorized_official_telephone_number": "9413004440", "authorized_official_title_or_position": "President & CEO", "certification_date": "2024-01-30", "enumeration_date": "2021-06-07", "last_updated": "2024-01-30", "organization_name": "CAN COMMUNITY HEALTH, INC.", "organizational_subpart": "NO", "status": "A" }, "created_epoch": "1623086921000", "endpoints": [], "enumeration_type": "NPI-2", "identifiers": [], "last_updated_epoch": "1706649032000", "number": "1306413604", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207Q00000X", "desc": "Family Medicine", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207R00000X", "desc": "Internal Medicine", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "363LP0808X", "desc": "Nurse Practitioner, Psych/Mental Health", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "363LW0102X", "desc": "Nurse Practitioner, Women's Health", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": null, "primary": true, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" } ] }, { "addresses": [ { "address_1": "PO BOX 1000 DEPT 394", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "941-404-1760", "postal_code": "381480001", "state": "TN", "telephone_number": "941-300-4440" }, { "address_1": "6315 N CENTER DR STE 100", "address_purpose": "LOCATION", "address_type": "DOM", "city": "NORFOLK", "country_code": "US", "country_name": "United States", "fax_number": "866-292-0928", "postal_code": "235020010", "state": "VA", "telephone_number": "757-346-5770" } ], "basic": { "authorized_official_first_name": "RISHI", "authorized_official_last_name": "PATEL", "authorized_official_middle_name": "B", "authorized_official_telephone_number": "9413004440", "authorized_official_title_or_position": "President & CEO", "certification_date": "2025-06-05", "enumeration_date": "2021-06-07", "last_updated": "2025-06-05", "organization_name": "CAN COMMUNITY HEALTH, INC.", "organizational_subpart": "NO", "status": "A" }, "created_epoch": "1623086076000", "endpoints": [], "enumeration_type": "NPI-2", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "1104829274", "issuer": null, "state": "VA" } ], "last_updated_epoch": "1749102392000", "number": "1366019663", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207Q00000X", "desc": "Family Medicine", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207R00000X", "desc": "Internal Medicine", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "363LF0000X", "desc": "Nurse Practitioner, Family", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "363LP0808X", "desc": "Nurse Practitioner, Psych/Mental Health", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": null, "primary": true, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" } ] }, { "addresses": [ { "address_1": "315 SE 14TH ST", "address_purpose": "LOCATION", "address_type": "DOM", "city": "FT LAUDERDALE", "country_code": "US", "country_name": "United States", "fax_number": "855-643-6201", "postal_code": "333161929", "state": "FL", "telephone_number": "754-701-6920" }, { "address_1": "PO BOX 1000 DEPT 394", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "941-404-1760", "postal_code": "381480001", "state": "TN", "telephone_number": "941-300-4440" } ], "basic": { "authorized_official_first_name": "RISHI", "authorized_official_last_name": "PATEL", "authorized_official_middle_name": "B", "authorized_official_telephone_number": "9413004440", "authorized_official_title_or_position": "President & CEO", "certification_date": "2024-01-30", "enumeration_date": "2021-06-04", "last_updated": "2024-01-30", "organization_name": "CAN COMMUNITY HEALTH, INC.", "organizational_subpart": "NO", "status": "A" }, "created_epoch": "1622850036000", "endpoints": [], "enumeration_type": "NPI-2", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "057256012", "issuer": null, "state": "FL" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "21725", "issuer": "FL BCBS Group #", "state": null } ], "last_updated_epoch": "1706648619000", "number": "1174190524", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "1041C0700X", "desc": "Social Worker, Clinical", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207Q00000X", "desc": "Family Medicine", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207R00000X", "desc": "Internal Medicine", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "363LP0808X", "desc": "Nurse Practitioner, Psych/Mental Health", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": null, "primary": true, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" } ] }, { "addresses": [ { "address_1": "PO BOX 1000 DEPT 394", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "941-404-1760", "postal_code": "381480001", "state": "TN", "telephone_number": "941-300-4440" }, { "address_1": "4350 FOWLER ST STE 2", "address_purpose": "LOCATION", "address_type": "DOM", "city": "FORT MYERS", "country_code": "US", "country_name": "United States", "fax_number": "855-576-5116", "postal_code": "339012600", "state": "FL", "telephone_number": "239-837-8187" } ], "basic": { "authorized_official_first_name": "RISHI", "authorized_official_last_name": "PATEL", "authorized_official_middle_name": "B", "authorized_official_telephone_number": "9413004440", "authorized_official_title_or_position": "President & CEO", "certification_date": "2025-01-22", "enumeration_date": "2025-01-22", "last_updated": "2025-01-22", "organization_name": "CAN COMMUNITY HEALTH, INC.", "organizational_subpart": "NO", "status": "A" }, "created_epoch": "1737575102000", "endpoints": [], "enumeration_type": "NPI-2", "identifiers": [], "last_updated_epoch": "1737575102000", "number": "1194537647", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "101YM0800X", "desc": "Counselor, Mental Health", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "1041C0700X", "desc": "Social Worker, Clinical", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "1223G0001X", "desc": "Dentist, General Practice", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207R00000X", "desc": "Internal Medicine", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": null, "primary": true, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "2084P0800X", "desc": "Psychiatry & Neurology, Psychiatry", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "363LF0000X", "desc": "Nurse Practitioner, Family", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "363LP0808X", "desc": "Nurse Practitioner, Psych/Mental Health", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "363LW0102X", "desc": "Nurse Practitioner, Women's Health", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" } ] }, { "addresses": [ { "address_1": "2349 SUNSET POINT RD STE 405", "address_purpose": "LOCATION", "address_type": "DOM", "city": "CLEARWATER", "country_code": "US", "country_name": "United States", "fax_number": "877-868-0981", "postal_code": "337651439", "state": "FL", "telephone_number": "727-216-6193" }, { "address_1": "PO BOX 1000 DEPT 394", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "941-404-1760", "postal_code": "381482558", "state": "TN", "telephone_number": "941-300-4440" } ], "basic": { "authorized_official_first_name": "RISHI", "authorized_official_last_name": "PATEL", "authorized_official_middle_name": "B", "authorized_official_telephone_number": "9413004440", "authorized_official_title_or_position": "President & CEO", "certification_date": "2024-01-30", "enumeration_date": "2021-06-04", "last_updated": "2024-01-30", "organization_name": "CAN COMMUNITY HEALTH, INC.", "organizational_subpart": "NO", "status": "A" }, "created_epoch": "1622851739000", "endpoints": [], "enumeration_type": "NPI-2", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "057256017", "issuer": null, "state": "FL" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "21725", "issuer": "FL BCBS Group #", "state": "FL" } ], "last_updated_epoch": "1706639450000", "number": "1154998516", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "101YM0800X", "desc": "Counselor, Mental Health", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207R00000X", "desc": "Internal Medicine", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "363LP0808X", "desc": "Nurse Practitioner, Psych/Mental Health", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": null, "primary": true, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" } ] }, { "addresses": [ { "address_1": "1301 W COLONIAL DR", "address_purpose": "LOCATION", "address_type": "DOM", "city": "ORLANDO", "country_code": "US", "country_name": "United States", "fax_number": "855-895-5749", "postal_code": "328047133", "state": "FL", "telephone_number": "407-246-1946" }, { "address_1": "PO BOX 1000 DEPT 394", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "941-404-1760", "postal_code": "381481926", "state": "TN", "telephone_number": "941-300-4440" } ], "basic": { "authorized_official_first_name": "RISHI", "authorized_official_last_name": "PATEL", "authorized_official_middle_name": "B", "authorized_official_telephone_number": "9413004440", "authorized_official_title_or_position": "President & CEO", "certification_date": "2024-01-30", "enumeration_date": "2021-06-07", "last_updated": "2024-01-30", "organization_name": "CAN COMMUNITY HEALTH, INC.", "organizational_subpart": "NO", "status": "A" }, "created_epoch": "1623076048000", "endpoints": [], "enumeration_type": "NPI-2", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "057256037", "issuer": null, "state": "FL" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "21725", "issuer": "BCBS FL Group #", "state": null } ], "last_updated_epoch": "1706645825000", "number": "1689241937", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "101YM0800X", "desc": "Counselor, Mental Health", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "363LW0102X", "desc": "Nurse Practitioner, Women's Health", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "1041C0700X", "desc": "Social Worker, Clinical", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207Q00000X", "desc": "Family Medicine", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207R00000X", "desc": "Internal Medicine", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "363AM0700X", "desc": "Physician Assistant, Medical", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "363LP0808X", "desc": "Nurse Practitioner, Psych/Mental Health", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": null, "primary": true, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" } ] }, { "addresses": [ { "address_1": "408 7TH ST W", "address_purpose": "LOCATION", "address_type": "DOM", "city": "PALMETTO", "country_code": "US", "country_name": "United States", "fax_number": "877-651-1335", "postal_code": "342215209", "state": "FL", "telephone_number": "941-803-7939" }, { "address_1": "PO BOX 1000 DEPT 394", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "941-404-1760", "postal_code": "381481926", "state": "TN", "telephone_number": "941-300-4440" } ], "basic": { "authorized_official_first_name": "RISHI", "authorized_official_last_name": "PATEL", "authorized_official_middle_name": "B", "authorized_official_telephone_number": "9413004440", "authorized_official_title_or_position": "President & CEO", "certification_date": "2024-01-30", "enumeration_date": "2021-06-07", "last_updated": "2024-01-30", "organization_name": "CAN COMMUNITY HEALTH, INC.", "organizational_subpart": "NO", "status": "A" }, "created_epoch": "1623072387000", "endpoints": [], "enumeration_type": "NPI-2", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "057256034", "issuer": null, "state": "FL" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "21725", "issuer": "FL BCBS Group #", "state": "FL" } ], "last_updated_epoch": "1706645996000", "number": "1144897489", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207R00000X", "desc": "Internal Medicine", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "101YM0800X", "desc": "Counselor, Mental Health", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207Q00000X", "desc": "Family Medicine", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": null, "primary": true, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" } ] }, { "addresses": [ { "address_1": "PO BOX 1000 DEPT 394", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "941-404-1760", "postal_code": "381481926", "state": "TN", "telephone_number": "941-300-4440" }, { "address_1": "18360 NW 47TH AVE", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MIAMI GARDENS", "country_code": "US", "country_name": "United States", "fax_number": "888-285-1741", "postal_code": "330552934", "state": "FL", "telephone_number": "786-800-5631" } ], "basic": { "authorized_official_first_name": "RISHI", "authorized_official_last_name": "PATEL", "authorized_official_middle_name": "B", "authorized_official_telephone_number": "9413004440", "authorized_official_title_or_position": "President & CEO", "certification_date": "2024-01-30", "enumeration_date": "2021-06-07", "last_updated": "2024-01-30", "organization_name": "CAN COMMUNITY HEALTH, INC.", "organizational_subpart": "NO", "status": "A" }, "created_epoch": "1623075668000", "endpoints": [], "enumeration_type": "NPI-2", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "057256038", "issuer": null, "state": "FL" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "21725", "issuer": "FL BCBS Group #", "state": null } ], "last_updated_epoch": "1706640746000", "number": "1699342949", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "363LP0808X", "desc": "Nurse Practitioner, Psych/Mental Health", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "1041C0700X", "desc": "Social Worker, Clinical", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207Q00000X", "desc": "Family Medicine", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207R00000X", "desc": "Internal Medicine", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": null, "primary": true, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" } ] }, { "addresses": [ { "address_1": "PO BOX 1000 DEPT 394", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "941-404-1760", "postal_code": "381480001", "state": "TN", "telephone_number": "941-300-4440" }, { "address_1": "4244 N 19TH AVE", "address_purpose": "LOCATION", "address_type": "DOM", "city": "PHOENIX", "country_code": "US", "country_name": "United States", "fax_number": "480-564-3762", "postal_code": "850155108", "state": "AZ", "telephone_number": "602-661-0666" } ], "basic": { "authorized_official_first_name": "RISHI", "authorized_official_last_name": "PATEL", "authorized_official_middle_name": "B", "authorized_official_telephone_number": "9413004440", "authorized_official_title_or_position": "President & CEO", "certification_date": "2024-02-26", "enumeration_date": "2021-06-07", "last_updated": "2024-02-26", "organization_name": "CAN COMMUNITY HEALTH, INC.", "organizational_subpart": "NO", "status": "A" }, "created_epoch": "1623086910000", "endpoints": [], "enumeration_type": "NPI-2", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "004921", "issuer": null, "state": "AZ" } ], "last_updated_epoch": "1708976155000", "number": "1598332892", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207Q00000X", "desc": "Family Medicine", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207R00000X", "desc": "Internal Medicine", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "363AM0700X", "desc": "Physician Assistant, Medical", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "363LW0102X", "desc": "Nurse Practitioner, Women's Health", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": null, "primary": true, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" } ] }, { "addresses": [ { "address_1": "PO BOX 1000 DEPT 394", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "941-404-1760", "postal_code": "381480001", "state": "TN", "telephone_number": "941-300-4440" }, { "address_1": "601 MATLOCK CENTRE CIR", "address_purpose": "LOCATION", "address_type": "DOM", "city": "ARLINGTON", "country_code": "US", "country_name": "United States", "fax_number": "904-293-4222", "postal_code": "760152535", "state": "TX", "telephone_number": "817-693-1000" } ], "basic": { "authorized_official_first_name": "RISHI", "authorized_official_last_name": "PATEL", "authorized_official_middle_name": "B", "authorized_official_telephone_number": "9413004440", "authorized_official_title_or_position": "President & CEO", "certification_date": "2024-01-30", "enumeration_date": "2021-06-07", "last_updated": "2024-01-30", "organization_name": "CAN COMMUNITY HEALTH, INC.", "organizational_subpart": "NO", "status": "A" }, "created_epoch": "1623087324000", "endpoints": [], "enumeration_type": "NPI-2", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "4235830", "issuer": null, "state": "TX" } ], "last_updated_epoch": "1706649823000", "number": "1487221784", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "1223G0001X", "desc": "Dentist, General Practice", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207Q00000X", "desc": "Family Medicine", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207R00000X", "desc": "Internal Medicine", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "363AM0700X", "desc": "Physician Assistant, Medical", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "363LW0102X", "desc": "Nurse Practitioner, Women's Health", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": null, "primary": true, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" } ] }, { "addresses": [ { "address_1": "4101 NW 3RD CT STE 9", "address_purpose": "LOCATION", "address_type": "DOM", "city": "PLANTATION", "country_code": "US", "country_name": "United States", "fax_number": "877-598-1604", "postal_code": "333172830", "state": "FL", "telephone_number": "754-701-6911" }, { "address_1": "PO BOX 1000 DEPT 394", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "941-404-1760", "postal_code": "381481926", "state": "TN", "telephone_number": "941-300-4440" } ], "basic": { "authorized_official_first_name": "RISHI", "authorized_official_last_name": "PATEL", "authorized_official_middle_name": "B", "authorized_official_telephone_number": "9413004440", "authorized_official_title_or_position": "President & CEO", "certification_date": "2024-01-30", "enumeration_date": "2021-06-04", "last_updated": "2024-01-30", "organization_name": "CAN COMMUNITY HEALTH, INC.", "organizational_subpart": "NO", "status": "A" }, "created_epoch": "1622850711000", "endpoints": [], "enumeration_type": "NPI-2", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "057256013", "issuer": null, "state": "FL" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "21725", "issuer": "BCBS FL Group #", "state": "FL" } ], "last_updated_epoch": "1706639321000", "number": "1518534965", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "1223G0001X", "desc": "Dentist, General Practice", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207Q00000X", "desc": "Family Medicine", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207R00000X", "desc": "Internal Medicine", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": null, "primary": true, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" } ] }, { "addresses": [ { "address_1": "1825 HURLBURT RD STE 14", "address_purpose": "LOCATION", "address_type": "DOM", "city": "FORT WALTON BEACH", "country_code": "US", "country_name": "United States", "fax_number": "844-297-8690", "postal_code": "325473737", "state": "FL", "telephone_number": "850-610-8820" }, { "address_1": "PO BOX 1000 DEPT 394", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "941-404-1760", "postal_code": "381481926", "state": "TN", "telephone_number": "941-300-4440" } ], "basic": { "authorized_official_first_name": "RISHI", "authorized_official_last_name": "PATEL", "authorized_official_middle_name": "B", "authorized_official_telephone_number": "9413004440", "authorized_official_title_or_position": "President & CEO", "certification_date": "2024-01-30", "enumeration_date": "2021-06-06", "last_updated": "2024-01-30", "organization_name": "CAN COMMUNITY HEALTH, INC.", "organizational_subpart": "NO", "status": "A" }, "created_epoch": "1623031605000", "endpoints": [], "enumeration_type": "NPI-2", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "057256024", "issuer": null, "state": "FL" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "21725", "issuer": "FL BCBS Group #", "state": "FL" } ], "last_updated_epoch": "1706639969000", "number": "1437726759", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "101YM0800X", "desc": "Counselor, Mental Health", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "1041C0700X", "desc": "Social Worker, Clinical", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207R00000X", "desc": "Internal Medicine", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "363AM0700X", "desc": "Physician Assistant, Medical", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "363LP0808X", "desc": "Nurse Practitioner, Psych/Mental Health", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": null, "primary": true, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" } ] }, { "addresses": [ { "address_1": "4758 ROWAN RD", "address_purpose": "LOCATION", "address_type": "DOM", "city": "NEW PORT RICHEY", "country_code": "US", "country_name": "United States", "fax_number": "888-806-9655", "postal_code": "346535601", "state": "FL", "telephone_number": "727-312-2040" }, { "address_1": "PO BOX 1000 DEPT 394", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "941-404-1760", "postal_code": "381480001", "state": "TN", "telephone_number": "941-300-4440" } ], "basic": { "authorized_official_first_name": "RISHI", "authorized_official_last_name": "PATEL", "authorized_official_middle_name": "B", "authorized_official_telephone_number": "9413004440", "authorized_official_title_or_position": "President & CEO", "certification_date": "2024-01-30", "enumeration_date": "2021-06-07", "last_updated": "2024-01-30", "organization_name": "CAN COMMUNITY HEALTH, INC.", "organizational_subpart": "NO", "status": "A" }, "created_epoch": "1623068175000", "endpoints": [], "enumeration_type": "NPI-2", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "057256014", "issuer": null, "state": "FL" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "21725", "issuer": "FL BCBS Group #", "state": "FL" } ], "last_updated_epoch": "1706648486000", "number": "1114594447", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207R00000X", "desc": "Internal Medicine", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "363LF0000X", "desc": "Nurse Practitioner, Family", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "363LP0808X", "desc": "Nurse Practitioner, Psych/Mental Health", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "101YM0800X", "desc": "Counselor, Mental Health", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "1223G0001X", "desc": "Dentist, General Practice", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": null, "primary": true, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" } ] }, { "addresses": [ { "address_1": "PO BOX 1000 DEPT 394", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "941-404-1760", "postal_code": "381482558", "state": "TN", "telephone_number": "941-300-4440" }, { "address_1": "1231 N TUTTLE AVE", "address_purpose": "LOCATION", "address_type": "DOM", "city": "SARASOTA", "country_code": "US", "country_name": "United States", "fax_number": "866-622-3009", "postal_code": "342373116", "state": "FL", "telephone_number": "941-366-0134" } ], "basic": { "authorized_official_first_name": "RISHI", "authorized_official_last_name": "PATEL", "authorized_official_middle_name": "B", "authorized_official_telephone_number": "9413004440", "authorized_official_title_or_position": "President & CEO", "certification_date": "2026-02-11", "enumeration_date": "2005-05-23", "last_updated": "2026-02-11", "organization_name": "CAN COMMUNITY HEALTH, INC.", "organizational_subpart": "NO", "status": "A" }, "created_epoch": "1116874413000", "endpoints": [], "enumeration_type": "NPI-2", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "057256000", "issuer": null, "state": "FL" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "21725", "issuer": "BCBS FL Group #", "state": "FL" } ], "last_updated_epoch": "1770820040000", "number": "1104829274", "other_names": [ { "code": "4", "organization_name": "COMPREHENSIVE CARE CENTER DBA COMMUNITY AIDS NETWORK", "type": "Former Legal Business Name" } ], "practiceLocations": [ { "address_1": "4244 N 19TH AVE", "address_purpose": "LOCATION", "address_type": "DOM", "city": "PHOENIX", "country_code": "US", "country_name": "United States", "fax_number": "877-869-9199", "postal_code": "850155108", "state": "AZ", "telephone_number": "602-661-0666" }, { "address_1": "2349 SUNSET POINT RD STE A", "address_purpose": "LOCATION", "address_type": "DOM", "city": "CLEARWATER", "country_code": "US", "country_name": "United States", "fax_number": "877-868-0981", "postal_code": "337651456", "state": "FL", "telephone_number": "727-216-6193" }, { "address_1": "1911 HAMPTON ST", "address_purpose": "LOCATION", "address_type": "DOM", "city": "COLUMBIA", "country_code": "US", "country_name": "United States", "fax_number": "877-826-1561", "postal_code": "292013535", "state": "SC", "telephone_number": "803-849-8430" }, { "address_1": "315 SE 14TH ST", "address_purpose": "LOCATION", "address_type": "DOM", "city": "FT LAUDERDALE", "country_code": "US", "country_name": "United States", "fax_number": "855-643-6201", "postal_code": "333161929", "state": "FL", "telephone_number": "754-701-6920" }, { "address_1": "4758 ROWAN RD", "address_purpose": "LOCATION", "address_type": "DOM", "city": "NEW PORT RICHEY", "country_code": "US", "country_name": "United States", "fax_number": "888-806-9655", "postal_code": "346535601", "state": "FL", "telephone_number": "727-312-2040" }, { "address_1": "1825 HURLBURT RD STE 14", "address_purpose": "LOCATION", "address_type": "DOM", "city": "FORT WALTON BEACH", "country_code": "US", "country_name": "United States", "fax_number": "844-297-8690", "postal_code": "325473737", "state": "FL", "telephone_number": "850-610-8820" }, { "address_1": "601 MATLOCK CENTRE CIR", "address_purpose": "LOCATION", "address_type": "DOM", "city": "ARLINGTON", "country_code": "US", "country_name": "United States", "fax_number": "904-293-4222", "postal_code": "760152535", "state": "TX", "telephone_number": "817-693-1000" }, { "address_1": "1820 E SAHARA AVE STE 200", "address_purpose": "LOCATION", "address_type": "DOM", "city": "LAS VEGAS", "country_code": "US", "country_name": "United States", "fax_number": "702-852-0439", "postal_code": "891043720", "state": "NV", "telephone_number": "702-979-1111" }, { "address_1": "4350 FOWLER ST STE 2", "address_purpose": "LOCATION", "address_type": "DOM", "city": "FORT MYERS", "country_code": "US", "country_name": "United States", "fax_number": "855-576-5116", "postal_code": "339012600", "state": "FL", "telephone_number": "239-837-8187" }, { "address_1": "3012 E COMMERCIAL BLVD", "address_purpose": "LOCATION", "address_type": "DOM", "city": "FORT LAUDERDALE", "country_code": "US", "country_name": "United States", "fax_number": "954-776-9993", "postal_code": "333084356", "state": "FL", "telephone_number": "954-776-9992" }, { "address_1": "1125 N NOVA RD", "address_purpose": "LOCATION", "address_type": "DOM", "city": "DAYTONA BEACH", "country_code": "US", "country_name": "United States", "fax_number": "877-242-5455", "postal_code": "321174108", "state": "FL", "telephone_number": "386-274-7651" }, { "address_1": "4211 CEDAR SPRINGS RD STE 200A", "address_purpose": "LOCATION", "address_type": "DOM", "city": "DALLAS", "country_code": "US", "country_name": "United States", "fax_number": "877-673-3560", "postal_code": "752192600", "state": "TX", "telephone_number": "945-351-0450" }, { "address_1": "4615 PHILIPS HWY STE 3", "address_purpose": "LOCATION", "address_type": "DOM", "city": "JACKSONVILLE", "country_code": "US", "country_name": "United States", "fax_number": "855-299-7010", "postal_code": "322079541", "state": "FL", "telephone_number": "904-508-0710" }, { "address_1": "201 N DIXIE HWY", "address_purpose": "LOCATION", "address_type": "DOM", "city": "LAKE WORTH", "country_code": "US", "country_name": "United States", "fax_number": "800-755-8631", "postal_code": "334603079", "state": "FL", "telephone_number": "561-867-9991" }, { "address_1": "427 WASHINGTON AVE", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MIAMI BEACH", "country_code": "US", "country_name": "United States", "fax_number": "855-235-4811", "postal_code": "331396617", "state": "FL", "telephone_number": "305-514-0813" }, { "address_1": "18360 NW 47TH AVE", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MIAMI GARDENS", "country_code": "US", "country_name": "United States", "fax_number": "888-285-1741", "postal_code": "330552934", "state": "FL", "telephone_number": "786-800-5631" }, { "address_1": "6315 N CENTER DR STE 100", "address_purpose": "LOCATION", "address_type": "DOM", "city": "NORFOLK", "country_code": "US", "country_name": "United States", "fax_number": "866-292-0928", "postal_code": "235020010", "state": "VA", "telephone_number": "757-346-5770" }, { "address_1": "14243 TAMIAMI TRL", "address_purpose": "LOCATION", "address_type": "DOM", "city": "NORTH PORT", "country_code": "US", "country_name": "United States", "fax_number": "888-213-0604", "postal_code": "342872215", "state": "FL", "telephone_number": "941-888-2144" }, { "address_1": "1301 W COLONIAL DR", "address_purpose": "LOCATION", "address_type": "DOM", "city": "ORLANDO", "country_code": "US", "country_name": "United States", "fax_number": "855-895-5749", "postal_code": "328047133", "state": "FL", "telephone_number": "407-246-1946" }, { "address_1": "408 7TH ST W", "address_purpose": "LOCATION", "address_type": "DOM", "city": "PALMETTO", "country_code": "US", "country_name": "United States", "fax_number": "877-651-1335", "postal_code": "342215209", "state": "FL", "telephone_number": "941-803-7939" }, { "address_1": "2105 N NEBRASKA AVE", "address_purpose": "LOCATION", "address_type": "DOM", "city": "TAMPA", "country_code": "US", "country_name": "United States", "fax_number": "844-722-0028", "postal_code": "336022558", "state": "FL", "telephone_number": "813-769-7207" }, { "address_1": "8390 N PALAFOX ST", "address_purpose": "LOCATION", "address_type": "DOM", "city": "PENSACOLA", "country_code": "US", "country_name": "United States", "fax_number": "877-266-7170", "postal_code": "325343735", "state": "FL", "telephone_number": "850-988-5245" }, { "address_1": "3251 3RD AVE N", "address_purpose": "LOCATION", "address_type": "DOM", "city": "ST PETERSBURG", "country_code": "US", "country_name": "United States", "fax_number": "855-896-5258", "postal_code": "337138506", "state": "FL", "telephone_number": "727-498-4969" } ], "taxonomies": [ { "code": "207R00000X", "desc": "Internal Medicine", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "101YM0800X", "desc": "Counselor, Mental Health", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "363LF0000X", "desc": "Nurse Practitioner, Family", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "1223G0001X", "desc": "Dentist, General Practice", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "363LP0808X", "desc": "Nurse Practitioner, Psych/Mental Health", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "1041C0700X", "desc": "Social Worker, Clinical", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "2084P0800X", "desc": "Psychiatry & Neurology, Psychiatry", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "363LW0102X", "desc": "Nurse Practitioner, Women's Health", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": null, "primary": true, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" } ] }, { "addresses": [ { "address_1": "1331 UNION AVE STE 1008", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-425-9768", "postal_code": "381047567", "state": "TN", "telephone_number": "901-881-3554" }, { "address_1": "1331 UNION AVE STE 1008", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-425-9768", "postal_code": "381047567", "state": "TN", "telephone_number": "901-881-3554" } ], "basic": { "certification_date": "2023-04-18", "credential": "MD", "enumeration_date": "2006-06-21", "first_name": "VLADIMIR", "last_name": "CHACHANIDZE", "last_updated": "2023-04-18", "name_prefix": "Dr.", "sex": "M", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1150868127000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [], "last_updated_epoch": "1681830839000", "number": "1750327607", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "E-4827", "primary": true, "state": "AR", "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": "901-448-6657", "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": "2006-04-27", "first_name": "KERRY", "last_name": "CLEVELAND", "last_updated": "2007-07-08", "middle_name": "O", "name_prefix": "Dr.", "name_suffix": "--", "sex": "M", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1146149040000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "3056005", "issuer": null, "state": "TN" } ], "last_updated_epoch": "1183947785000", "number": "1114984911", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "20984", "primary": true, "state": "TN", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "MEDICAL CENTER BLVD", "address_purpose": "MAILING", "address_type": "DOM", "city": "WINSTON SALEM", "country_code": "US", "country_name": "United States", "postal_code": "271570001", "state": "NC", "telephone_number": "336-716-2700" }, { "address_1": "MEDICAL CENTER BLVD", "address_purpose": "LOCATION", "address_type": "DOM", "city": "WINSTON SALEM", "country_code": "US", "country_name": "United States", "postal_code": "271570001", "state": "NC", "telephone_number": "336-716-2700" } ], "basic": { "certification_date": "2023-07-06", "credential": "MD", "enumeration_date": "2018-05-31", "first_name": "JULIA", "last_name": "COOK", "last_updated": "2023-07-06", "middle_name": "CHRISTINE", "name_prefix": "Dr.", "sex": "F", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1527800529000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [], "last_updated_epoch": "1688670462000", "number": "1619469103", "other_names": [], "practiceLocations": [ { "address_1": "UNIVERSITY OF TENNESEE", "address_2": "920 MADISON AVE, SUITE 447", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "postal_code": "38163", "state": "TN", "telephone_number": "901-448-5814" } ], "taxonomies": [ { "code": "390200000X", "desc": "Student in an Organized Health Care Education/Training Program", "license": null, "primary": false, "state": null, "taxonomy_group": "" }, { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "2023-01339", "primary": true, "state": "NC", "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": "2006-05-01", "first_name": "CATHY", "last_name": "CORBETT", "last_updated": "2007-07-08", "name_prefix": "Dr.", "name_suffix": "--", "sex": "F", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1146495573000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "3049695", "issuer": null, "state": "TN" } ], "last_updated_epoch": "1183947785000", "number": "1578520714", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "13444", "primary": true, "state": "TN", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "2500 N STATE ST", "address_purpose": "LOCATION", "address_type": "DOM", "city": "JACKSON", "country_code": "US", "country_name": "United States", "fax_number": "601-984-6439", "postal_code": "392164500", "state": "MS", "telephone_number": "601-984-6426" }, { "address_1": "965 RIDGE LAKE BLVD STE 315", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-227-8591", "postal_code": "381209401", "state": "TN" } ], "basic": { "certification_date": "2021-11-12", "credential": "MD", "enumeration_date": "2006-07-19", "first_name": "FRANK", "last_name": "CRIDDLE", "last_updated": "2021-11-12", "middle_name": "JEFFERSON", "name_prefix": "Dr.", "name_suffix": "III", "sex": "M", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1153310019000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "07076260", "issuer": null, "state": "MS" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "13166", "issuer": "Medical license number", "state": "MS" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "P01212522", "issuer": "Railroad Medicare", "state": "MS" } ], "last_updated_epoch": "1636739002000", "number": "1447279526", "other_names": [], "practiceLocations": [ { "address_1": "1225 N STATE ST", "address_purpose": "LOCATION", "address_type": "DOM", "city": "JACKSON", "country_code": "US", "country_name": "United States", "fax_number": "601-974-6241", "postal_code": "392022064", "state": "MS", "telephone_number": "601-988-5281" } ], "taxonomies": [ { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "13166", "primary": false, "state": "MS", "taxonomy_group": "" }, { "code": "207R00000X", "desc": "Internal Medicine", "license": "13166", "primary": true, "state": "MS", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "877 JEFFERSON AVE", "address_2": "ATTN: PROVIDER ENROLLMENT", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "postal_code": "381032807", "state": "TN", "telephone_number": "901-545-8336" }, { "address_1": "880 MADISON AVE", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-545-4739", "postal_code": "381033409", "state": "TN", "telephone_number": "901-545-6969" } ], "basic": { "credential": "MD", "enumeration_date": "2007-06-22", "first_name": "SARA", "last_name": "CROSS", "last_updated": "2015-08-06", "middle_name": "LYNNE", "name_prefix": "Dr.", "sex": "F", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1182543226000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [], "last_updated_epoch": "1438891866000", "number": "1194921551", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "50271", "primary": true, "state": "TN", "taxonomy_group": "" }, { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "2011025964", "primary": false, "state": "MO", "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": "2006-05-01", "first_name": "JAMES", "last_name": "DALE", "last_updated": "2007-07-08", "middle_name": "B", "name_prefix": "Dr.", "name_suffix": "--", "sex": "M", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1146495950000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "3841603", "issuer": null, "state": "TN" } ], "last_updated_epoch": "1183947785000", "number": "1548227689", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "14124", "primary": true, "state": "TN", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "806 S COOPER ST", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "postal_code": "381045406", "state": "TN", "telephone_number": "901-896-0739" }, { "address_1": "1548 POPLAR AVE", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-333-8255", "postal_code": "381042432", "state": "TN", "telephone_number": "901-333-8269" } ], "basic": { "authorized_official_first_name": "DIANE", "authorized_official_last_name": "DUKE", "authorized_official_telephone_number": "7472307297", "authorized_official_title_or_position": "CEO", "certification_date": "2024-04-05", "enumeration_date": "2021-10-28", "last_updated": "2024-04-05", "organization_name": "FRIENDS FOR LIFE CORPORATION", "organizational_subpart": "NO", "status": "A" }, "created_epoch": "1635451426000", "endpoints": [], "enumeration_type": "NPI-2", "identifiers": [], "last_updated_epoch": "1712337645000", "number": "1285398834", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": null, "primary": true, "state": null, "taxonomy_group": "193400000X - Multiple Single Specialty Group" }, { "code": "251S00000X", "desc": "Community/Behavioral Health", "license": null, "primary": false, "state": null, "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "880 MADISON AVE", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-545-7177", "postal_code": "381033409", "state": "TN", "telephone_number": "901-545-6969" }, { "address_1": "877 JEFFERSON AVE", "address_2": "ATTN: PROVIDER ENROLLMENT", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "postal_code": "381032807", "state": "TN" } ], "basic": { "certification_date": "2025-06-03", "enumeration_date": "2012-03-23", "first_name": "CHRISTIAN", "last_name": "FUCHS", "last_updated": "2025-06-03", "middle_name": "JAN", "sex": "M", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1332538010000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [], "last_updated_epoch": "1748954159000", "number": "1619243680", "other_names": [], "practiceLocations": [ { "address_1": "300 20TH AVE N STE 601", "address_purpose": "LOCATION", "address_type": "DOM", "city": "NASHVILLE", "country_code": "US", "country_name": "United States", "postal_code": "372035601", "state": "TN", "telephone_number": "615-284-5185" } ], "taxonomies": [ { "code": "390200000X", "desc": "Student in an Organized Health Care Education/Training Program", "license": null, "primary": false, "state": null, "taxonomy_group": "" }, { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "56003", "primary": true, "state": "TN", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "1211 UNION AVE STE 330", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "postal_code": "381046655", "state": "TN" }, { "address_1": "1265 UNION AVE", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-387-5153", "postal_code": "381043415", "state": "TN", "telephone_number": "901-758-7888" } ], "basic": { "certification_date": "2026-04-20", "credential": "MD", "enumeration_date": "2006-05-01", "first_name": "MICHAEL", "last_name": "GELFAND", "last_updated": "2026-04-20", "middle_name": "S", "name_prefix": "Dr.", "sex": "M", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1146512757000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "3190689", "issuer": null, "state": "TN" } ], "last_updated_epoch": "1776699559000", "number": "1982662961", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "12720", "primary": true, "state": "TN", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "1325 EASTMORELAND AVE STE 245", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-516-9817", "postal_code": "381043591", "state": "TN", "telephone_number": "901-516-9800" }, { "address_1": "1211 UNION AVE STE 330", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "postal_code": "381046655", "state": "TN" } ], "basic": { "certification_date": "2024-01-10", "credential": "MD", "enumeration_date": "2006-05-23", "first_name": "ELLENA", "last_name": "HENDERSON", "last_updated": "2024-01-10", "sex": "F", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1148387622000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "3716661", "issuer": null, "state": "TN" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "4097866", "issuer": "BCBS", "state": "TN" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "P00279007", "issuer": "RR Medicare", "state": "TN" } ], "last_updated_epoch": "1704921530000", "number": "1285689091", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "39177", "primary": false, "state": "TN", "taxonomy_group": "" }, { "code": "207R00000X", "desc": "Internal Medicine", "license": "39177", "primary": true, "state": "TN", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "262 DANNY THOMAS PL", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "postal_code": "38105", "state": "TN", "telephone_number": "901-595-3486" }, { "address_1": "735 COLEHERNE RD", "address_purpose": "MAILING", "address_type": "DOM", "city": "COLLIERVILLE", "country_code": "US", "country_name": "United States", "postal_code": "380177322", "state": "TN", "telephone_number": "615-970-9866" } ], "basic": { "certification_date": "2025-01-27", "credential": "M.D.", "enumeration_date": "2014-06-19", "first_name": "DIEGO", "last_name": "HIJANO", "last_updated": "2025-01-27", "middle_name": "RAUL", "name_prefix": "Dr.", "sex": "M", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1403205577000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [], "last_updated_epoch": "1738006456000", "number": "1093129827", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "2080P0208X", "desc": "Pediatrics, Pediatric Infectious Diseases", "license": "52271", "primary": true, "state": "TN", "taxonomy_group": "" }, { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "52271", "primary": false, "state": "TN", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "3025 KATE BOND RD", "address_purpose": "LOCATION", "address_type": "DOM", "city": "BARTLETT", "country_code": "US", "country_name": "United States", "postal_code": "381334004", "state": "TN", "telephone_number": "901-410-2159" }, { "address_1": "PO BOX 18361", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "postal_code": "381810361", "state": "TN", "telephone_number": "901-410-2159" } ], "basic": { "authorized_official_credential": "MD", "authorized_official_first_name": "TINA", "authorized_official_last_name": "AGBAOSI", "authorized_official_telephone_number": "9014102159", "authorized_official_title_or_position": "President", "enumeration_date": "2018-05-10", "last_updated": "2018-05-10", "organization_name": "INFECTIOUS DX SOLUTIONS PC", "organizational_subpart": "NO", "status": "A" }, "created_epoch": "1525973369000", "endpoints": [], "enumeration_type": "NPI-2", "identifiers": [], "last_updated_epoch": "1525973369000", "number": "1679063135", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": null, "primary": true, "state": "TN", "taxonomy_group": "193200000X - Multi-Specialty Group" } ] }, { "addresses": [ { "address_1": "8988 FOREST HILL IRENE CV", "address_purpose": "LOCATION", "address_type": "DOM", "city": "GERMANTOWN", "country_code": "US", "country_name": "United States", "fax_number": "901-365-1916", "postal_code": "381396619", "state": "TN", "telephone_number": "901-362-1411" }, { "address_1": "PO BOX 38449", "address_purpose": "MAILING", "address_type": "DOM", "city": "GERMANTOWN", "country_code": "US", "country_name": "United States", "postal_code": "381830449", "state": "TN", "telephone_number": "901-362-1411" } ], "basic": { "authorized_official_credential": "MD", "authorized_official_first_name": "MUHAMMAD", "authorized_official_last_name": "KHURSHID", "authorized_official_middle_name": "A", "authorized_official_telephone_number": "9013621411", "authorized_official_title_or_position": "Sole owner", "certification_date": "2022-01-04", "enumeration_date": "2008-09-04", "last_updated": "2022-01-04", "organization_name": "INTERNAL MEDICINE & INFECTIOUS DISEASES SPECIALISTS, PLLC", "organizational_subpart": "NO", "status": "A" }, "created_epoch": "1220539103000", "endpoints": [], "enumeration_type": "NPI-2", "identifiers": [], "last_updated_epoch": "1641312185000", "number": "1316195241", "other_names": [], "practiceLocations": [ { "address_1": "5959 PARK AVE", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "postal_code": "381195200", "state": "TN", "telephone_number": "901-362-1411" } ], "taxonomies": [ { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "43836", "primary": true, "state": "TN", "taxonomy_group": "193200000X - Multi-Specialty Group" } ] }, { "addresses": [ { "address_1": "6029 WALNUT GROVE RD STE 209", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-821-9987", "postal_code": "381202112", "state": "TN", "telephone_number": "901-681-0778" }, { "address_1": "6027 WALNUT GROVE RD", "address_2": "SUITE 312", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-821-9987", "postal_code": "381202145", "state": "TN", "telephone_number": "901-681-0778" } ], "basic": { "certification_date": "2023-01-24", "credential": "MD, MPH", "enumeration_date": "2006-06-12", "first_name": "MANOJ", "last_name": "JAIN", "last_updated": "2023-01-24", "middle_name": "K", "sex": "M", "sole_proprietor": "YES", "status": "A" }, "created_epoch": "1150145552000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "000116301", "issuer": null, "state": "MS" }, { "code": "05", "desc": "MEDICAID", "identifier": "3090453", "issuer": null, "state": "TN" } ], "last_updated_epoch": "1674574202000", "number": "1003858168", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "md0000026445", "primary": true, "state": "TN", "taxonomy_group": "" }, { "code": "207R00000X", "desc": "Internal Medicine", "license": "md0000026445", "primary": false, "state": "TN", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "1200 N STATE ST", "address_2": "STE 500", "address_purpose": "LOCATION", "address_type": "DOM", "city": "JACKSON", "country_code": "US", "country_name": "United States", "fax_number": "601-714-3415", "postal_code": "392022000", "state": "MS", "telephone_number": "601-352-2273" }, { "address_1": "965 RIDGE LAKE BLVD STE 103", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-227-3205", "postal_code": "381209446", "state": "TN", "telephone_number": "901-227-3255" } ], "basic": { "credential": "MD", "enumeration_date": "2009-07-02", "first_name": "AYESHA", "last_name": "KHALID", "last_updated": "2018-03-15", "name_prefix": "Dr.", "sex": "F", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1246538789000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "00905368", "issuer": null, "state": "MS" } ], "last_updated_epoch": "1521122706000", "number": "1679702302", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "22945", "primary": true, "state": "MS", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "8988 FOREST HILL IRENE CV", "address_purpose": "LOCATION", "address_type": "DOM", "city": "GERMANTOWN", "country_code": "US", "country_name": "United States", "postal_code": "381396619", "state": "TN", "telephone_number": "901-362-1411" }, { "address_1": "PO BOX 38449", "address_purpose": "MAILING", "address_type": "DOM", "city": "GERMANTOWN", "country_code": "US", "country_name": "United States", "fax_number": "901-365-1916", "postal_code": "381830449", "state": "TN", "telephone_number": "901-362-1411" } ], "basic": { "certification_date": "2021-11-17", "credential": "MD", "enumeration_date": "2007-06-13", "first_name": "MUHAMMAD", "last_name": "KHURSHID", "last_updated": "2026-02-12", "middle_name": "AIJAZ", "name_prefix": "Dr.", "sex": "M", "sole_proprietor": "YES", "status": "A" }, "created_epoch": "1181764494000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "01", "desc": "Other (non-Medicare)", "identifier": "01903448", "issuer": "Amerigroup", "state": "TN" }, { "code": "05", "desc": "MEDICAID", "identifier": "1512192", "issuer": null, "state": "TN" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "3002324", "issuer": "MEDICARE", "state": "TN" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "4208554", "issuer": "BCBS", "state": "TN" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "8238477", "issuer": "Cigna", "state": "TN" } ], "last_updated_epoch": "1770932688000", "number": "1932303856", "other_names": [], "practiceLocations": [ { "address_1": "5959 PARK AVE", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "postal_code": "381195200", "state": "TN", "telephone_number": "901-362-1411" } ], "taxonomies": [ { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "MD43836", "primary": true, "state": "TN", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "6029 WALNUT GROVE RD STE 209", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-821-9987", "postal_code": "381202112", "state": "TN", "telephone_number": "901-681-0778" }, { "address_1": "6029 WALNUT GROVE RD STE 209", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-821-9987", "postal_code": "381202112", "state": "TN", "telephone_number": "901-681-0778" } ], "basic": { "certification_date": "2025-08-12", "credential": "M.D,", "enumeration_date": "2020-06-19", "first_name": "VISHAK", "last_name": "KUMAR", "last_updated": "2025-08-12", "middle_name": "HARI", "name_prefix": "Dr.", "sex": "M", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1592578375000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [], "last_updated_epoch": "1755005465000", "number": "1801412416", "other_names": [ { "code": "1", "first_name": "VISHAK", "last_name": "NAIR", "middle_name": "HARI", "type": "Former Name" } ], "practiceLocations": [], "taxonomies": [ { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "73316", "primary": true, "state": "TN", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "6029 WALNUT GROVE RD STE C002", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "postal_code": "381202112", "state": "TN", "telephone_number": "901-685-3490" }, { "address_1": "6799 GREAT OAKS RD STE 250", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-685-3499", "postal_code": "381382584", "state": "TN", "telephone_number": "901-685-3490" } ], "basic": { "credential": "M.D.", "enumeration_date": "2006-06-10", "first_name": "MARGARITA", "last_name": "LAMOTHE", "last_updated": "2019-01-07", "sex": "F", "sole_proprietor": "YES", "status": "A" }, "created_epoch": "1149934564000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "00113067", "issuer": null, "state": "MS" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "0822233", "issuer": "BCBS of TN", "state": "TN" }, { "code": "05", "desc": "MEDICAID", "identifier": "3060256", "issuer": null, "state": "TN" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "95001", "issuer": "BCBS of AR", "state": "AR" } ], "last_updated_epoch": "1546893545000", "number": "1306887187", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "MD018339", "primary": true, "state": "TN", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "877 JEFFERSON AVE", "address_2": "ATTN: PROVIDER ENROLLMENT", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "postal_code": "381032807", "state": "TN", "telephone_number": "901-545-8336" }, { "address_1": "880 MADISON AVE", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-545-7177", "postal_code": "381033409", "state": "TN", "telephone_number": "901-545-6969" } ], "basic": { "credential": "M.D.", "enumeration_date": "2006-07-10", "first_name": "MACK", "last_name": "LAND", "last_updated": "2015-02-11", "middle_name": "A", "name_prefix": "--", "name_suffix": "--", "sex": "M", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1152507019000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "00010933", "issuer": null, "state": "MS" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "23973", "issuer": "BCBS of TN", "state": "TN" }, { "code": "05", "desc": "MEDICAID", "identifier": "3199828", "issuer": null, "state": "TN" } ], "last_updated_epoch": "1423692086000", "number": "1760415756", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "MD8514", "primary": true, "state": "TN", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "6029 WALNUT GROVE RD STE 209", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-821-9987", "postal_code": "381202112", "state": "TN", "telephone_number": "901-681-0778" }, { "address_1": "6029 WALNUT GROVE RD STE 209", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-821-9987", "postal_code": "381202112", "state": "TN", "telephone_number": "901-681-0778" } ], "basic": { "certification_date": "2023-01-24", "credential": "M.D.", "enumeration_date": "2006-05-24", "first_name": "GHALIB", "last_name": "MANNAN", "last_updated": "2023-01-24", "sex": "M", "sole_proprietor": "YES", "status": "A" }, "created_epoch": "1148480410000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "000124232", "issuer": null, "state": "MS" }, { "code": "05", "desc": "MEDICAID", "identifier": "3865813", "issuer": null, "state": "TN" }, { "code": "05", "desc": "MEDICAID", "identifier": "3865814", "issuer": null, "state": "TN" } ], "last_updated_epoch": "1674574303000", "number": "1831144013", "other_names": [], "practiceLocations": [ { "address_1": "7601 SOUTHCREST PKWY", "address_purpose": "LOCATION", "address_type": "DOM", "city": "SOUTHAVEN", "country_code": "US", "country_name": "United States", "fax_number": "901-821-9987", "postal_code": "386714739", "state": "MS", "telephone_number": "901-681-0778" } ], "taxonomies": [ { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "17199", "primary": true, "state": "MS", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "1068 CRESTHAVEN RD", "address_2": "SUITE 250", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-685-3499", "postal_code": "381190800", "state": "TN", "telephone_number": "901-684-3490" }, { "address_1": "1068 CRESTHAVEN RD", "address_2": "SUITE 250", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-685-3499", "postal_code": "381190800", "state": "TN", "telephone_number": "901-684-3490" } ], "basic": { "credential": "MD", "enumeration_date": "2007-01-04", "first_name": "WILLIAM", "last_name": "MASON", "last_updated": "2011-07-05", "middle_name": "JEFFREY", "name_prefix": "Dr.", "name_suffix": "--", "sex": "M", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1167939358000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [], "last_updated_epoch": "1309905564000", "number": "1467509349", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "MD0000041126", "primary": true, "state": "TN", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "1211 UNION AVE STE 330", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "postal_code": "381046655", "state": "TN" }, { "address_1": "1325 EASTMORELAND AVE STE 360", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-516-8550", "postal_code": "381047514", "state": "TN", "telephone_number": "901-516-8714" } ], "basic": { "certification_date": "2026-02-05", "credential": "md", "enumeration_date": "2008-01-16", "first_name": "SHIRIN", "last_name": "MAZUMDER", "last_updated": "2026-02-05", "name_prefix": "Dr.", "sex": "F", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1200534789000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "01", "desc": "Other (non-Medicare)", "identifier": "103I441427", "issuer": "Medicare", "state": "TN" }, { "code": "05", "desc": "MEDICAID", "identifier": "1523865", "issuer": null, "state": "TN" } ], "last_updated_epoch": "1770313908000", "number": "1396921623", "other_names": [], "practiceLocations": [ { "address_1": "57 GERMANTOWN CT STE 100", "address_purpose": "LOCATION", "address_type": "DOM", "city": "CORDOVA", "country_code": "US", "country_name": "United States", "fax_number": "901-266-6445", "postal_code": "380184274", "state": "TN", "telephone_number": "901-758-7888" }, { "address_1": "1211 UNION AVE STE 200", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-526-9014", "postal_code": "381046654", "state": "TN", "telephone_number": "901-525-0278" } ], "taxonomies": [ { "code": "207R00000X", "desc": "Internal Medicine", "license": "125049079", "primary": false, "state": "IL", "taxonomy_group": "" }, { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "47374", "primary": true, "state": "TN", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "969 LAKELAND DR", "address_purpose": "LOCATION", "address_type": "DOM", "city": "JACKSON", "country_code": "US", "country_name": "United States", "fax_number": "601-200-4718", "postal_code": "392164606", "state": "MS", "telephone_number": "601-200-4714" }, { "address_1": "965 RIDGE LAKE BLVD STE 315", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-227-8591", "postal_code": "381209401", "state": "TN" } ], "basic": { "certification_date": "2021-08-06", "credential": "M.D.", "enumeration_date": "2005-11-10", "first_name": "ERIC", "last_name": "MCVEY", "last_updated": "2021-08-06", "middle_name": "ALEXANDER", "name_prefix": "Mr.", "name_suffix": "III", "sex": "M", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1131654375000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "00016957", "issuer": null, "state": "MS" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "P01186241", "issuer": "RAILROAD MEDICARE", "state": "MS" } ], "last_updated_epoch": "1628254833000", "number": "1467433995", "other_names": [], "practiceLocations": [ { "address_1": "1200 N STATE ST STE 500", "address_purpose": "LOCATION", "address_type": "DOM", "city": "JACKSON", "country_code": "US", "country_name": "United States", "fax_number": "601-714-3215", "postal_code": "392022027", "state": "MS", "telephone_number": "601-352-2273" } ], "taxonomies": [ { "code": "174400000X", "desc": "Specialist", "license": "07687", "primary": false, "state": "MS", "taxonomy_group": "" }, { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "07687", "primary": true, "state": "MS", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "350 N HUMPHREYS BLVD", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "601-292-4262", "postal_code": "381202177", "state": "TN", "telephone_number": "601-292-4261" }, { "address_1": "1200 N STATE ST STE 270", "address_purpose": "LOCATION", "address_type": "DOM", "city": "JACKSON", "country_code": "US", "country_name": "United States", "fax_number": "601-353-4414", "postal_code": "392022027", "state": "MS", "telephone_number": "601-974-6246" } ], "basic": { "authorized_official_first_name": "GREGORY", "authorized_official_last_name": "DUCKETT", "authorized_official_middle_name": "M", "authorized_official_telephone_number": "9012275233", "authorized_official_title_or_position": "SR VP/CLO", "certification_date": "2020-10-01", "enumeration_date": "2006-03-14", "last_updated": "2020-10-06", "organization_name": "MEDICAL FOUNDATION OF CENTRAL MISSISSIPPI, INC.", "organizational_subpart": "YES", "parent_organization_legal_business_name": "BAPTIST MEMORIAL HEALTH CARE CORP.", "status": "A" }, "created_epoch": "1142381284000", "endpoints": [], "enumeration_type": "NPI-2", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "03807380", "issuer": null, "state": "MS" } ], "last_updated_epoch": "1601991630000", "number": "1992774814", "other_names": [ { "code": "3", "organization_name": "BAPTIST MEDICAL CLINICS", "type": "Doing Business As" } ], "practiceLocations": [ { "address_1": "1190 N STATE ST", "address_purpose": "LOCATION", "address_type": "DOM", "city": "JACKSON", "country_code": "US", "country_name": "United States", "fax_number": "601-973-1596", "postal_code": "392022413", "state": "MS", "telephone_number": "601-973-1624" }, { "address_1": "1200 N STATE ST STE 500", "address_purpose": "LOCATION", "address_type": "DOM", "city": "JACKSON", "country_code": "US", "country_name": "United States", "fax_number": "601-714-3215", "postal_code": "392022027", "state": "MS", "telephone_number": "601-352-2273" }, { "address_1": "823 GRAND AVE", "address_purpose": "LOCATION", "address_type": "DOM", "city": "YAZOO CITY", "country_code": "US", "country_name": "United States", "fax_number": "662-746-7855", "postal_code": "391943233", "state": "MS", "telephone_number": "627-518-2466" }, { "address_1": "1200 N STATE ST # LL10", "address_purpose": "LOCATION", "address_type": "DOM", "city": "JACKSON", "country_code": "US", "country_name": "United States", "fax_number": "601-362-8116", "postal_code": "392022000", "state": "MS", "telephone_number": "601-362-7280" }, { "address_1": "401 BAPTIST DR STE 206", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MADISON", "country_code": "US", "country_name": "United States", "fax_number": "601-973-1609", "postal_code": "391102011", "state": "MS", "telephone_number": "601-973-1583" }, { "address_1": "1490 W GOVERNMENT ST STE 10", "address_purpose": "LOCATION", "address_type": "DOM", "city": "BRANDON", "country_code": "US", "country_name": "United States", "fax_number": "601-825-1937", "postal_code": "390423024", "state": "MS", "telephone_number": "601-825-1936" }, { "address_1": "123 BO BO DR", "address_purpose": "LOCATION", "address_type": "DOM", "city": "CRYSTAL SPRINGS", "country_code": "US", "country_name": "United States", "fax_number": "601-973-4541", "postal_code": "390592741", "state": "MS", "telephone_number": "601-969-6404" }, { "address_1": "1100 HWY 16", "address_purpose": "LOCATION", "address_type": "DOM", "city": "CARTHAGE", "country_code": "US", "country_name": "United States", "fax_number": "601-973-4541", "postal_code": "39051", "state": "MS", "telephone_number": "601-267-1000" }, { "address_1": "7275 S SIWELL RD", "address_purpose": "LOCATION", "address_type": "DOM", "city": "BYRAM", "country_code": "US", "country_name": "United States", "fax_number": "601-373-7378", "postal_code": "392729767", "state": "MS", "telephone_number": "601-373-7722" }, { "address_1": "1100 HWY 16", "address_purpose": "LOCATION", "address_type": "DOM", "city": "CARTHAGE", "country_code": "US", "country_name": "United States", "fax_number": "601-973-4541", "postal_code": "39051", "state": "MS", "telephone_number": "601-267-1000" }, { "address_1": "332 HIGHWAY 12 W", "address_purpose": "LOCATION", "address_type": "DOM", "city": "KOSCIUSKO", "country_code": "US", "country_name": "United States", "fax_number": "662-289-2486", "postal_code": "390903209", "state": "MS", "telephone_number": "601-289-1800" }, { "address_1": "106 CLINTON PKWY", "address_purpose": "LOCATION", "address_type": "DOM", "city": "CLINTON", "country_code": "US", "country_name": "United States", "fax_number": "601-973-1622", "postal_code": "390564730", "state": "MS", "telephone_number": "601-924-9005" }, { "address_1": "151 E METRO DR STE 103", "address_purpose": "LOCATION", "address_type": "DOM", "city": "FLOWOOD", "country_code": "US", "country_name": "United States", "fax_number": "601-992-3188", "postal_code": "392324405", "state": "MS", "telephone_number": "601-992-3288" }, { "address_1": "401 BAPTIST DR STE 104", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MADISON", "country_code": "US", "country_name": "United States", "fax_number": "601-605-3898", "postal_code": "391102010", "state": "MS", "telephone_number": "601-605-2383" }, { "address_1": "2173 MAIN ST", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MADISON", "country_code": "US", "country_name": "United States", "fax_number": "601-605-3898", "postal_code": "391106309", "state": "MS", "telephone_number": "601-605-3858" }, { "address_1": "650 OLD CANTON RD STE 100", "address_purpose": "LOCATION", "address_type": "DOM", "city": "JACKSON", "country_code": "US", "country_name": "United States", "fax_number": "601-956-9721", "postal_code": "39211", "state": "MS", "telephone_number": "601-957-1015" }, { "address_1": "1887 SPILLWAY RD", "address_purpose": "LOCATION", "address_type": "DOM", "city": "BRANDON", "country_code": "US", "country_name": "United States", "fax_number": "601-992-5547", "postal_code": "390476066", "state": "MS", "telephone_number": "601-992-5532" }, { "address_1": "1201 HIGHWAY 49 S STE 1", "address_purpose": "LOCATION", "address_type": "DOM", "city": "RICHLAND", "country_code": "US", "country_name": "United States", "fax_number": "601-664-0055", "postal_code": "392189438", "state": "MS", "telephone_number": "601-973-1576" }, { "address_1": "102 LEXINGTON DR STE 100", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MADISON", "country_code": "US", "country_name": "United States", "fax_number": "601-973-1690", "postal_code": "391106952", "state": "MS", "telephone_number": "601-973-1688" }, { "address_1": "3011 GREENFIELD RD", "address_purpose": "LOCATION", "address_type": "DOM", "city": "PEARL", "country_code": "US", "country_name": "United States", "fax_number": "601-825-2531", "postal_code": "392088712", "state": "MS", "telephone_number": "601-825-9000" }, { "address_1": "1225 N STATE ST", "address_purpose": "LOCATION", "address_type": "DOM", "city": "JACKSON", "country_code": "US", "country_name": "United States", "fax_number": "601-974-6241", "postal_code": "392022064", "state": "MS", "telephone_number": "601-988-5281" }, { "address_1": "501 MARSHALL ST STE G07", "address_purpose": "LOCATION", "address_type": "DOM", "city": "JACKSON", "country_code": "US", "country_name": "United States", "fax_number": "601-968-3237", "postal_code": "392021651", "state": "MS", "telephone_number": "601-968-3238" }, { "address_1": "1200 N STATE ST STE 420", "address_purpose": "LOCATION", "address_type": "DOM", "city": "JACKSON", "country_code": "US", "country_name": "United States", "fax_number": "601-355-3365", "postal_code": "392022027", "state": "MS", "telephone_number": "601-355-3353" }, { "address_1": "100 S PEARSON RD", "address_purpose": "LOCATION", "address_type": "DOM", "city": "PEARL", "country_code": "US", "country_name": "United States", "fax_number": "601-968-1246", "postal_code": "39208", "state": "MS", "telephone_number": "601-968-1237" }, { "address_1": "1200 N STATE ST STE 210", "address_purpose": "LOCATION", "address_type": "DOM", "city": "JACKSON", "country_code": "US", "country_name": "United States", "fax_number": "601-714-3416", "postal_code": "392022000", "state": "MS", "telephone_number": "601-714-3202" }, { "address_1": "7273 S SIWELL RD", "address_purpose": "LOCATION", "address_type": "DOM", "city": "BYRAM", "country_code": "US", "country_name": "United States", "fax_number": "601-372-8125", "postal_code": "392729767", "state": "MS", "telephone_number": "601-372-8223" }, { "address_1": "108 CLINTON PKWY", "address_purpose": "LOCATION", "address_type": "DOM", "city": "CLINTON", "country_code": "US", "country_name": "United States", "fax_number": "601-924-9746", "postal_code": "390564730", "state": "MS", "telephone_number": "601-926-2018" }, { "address_1": "151 E METRO DR STE 202", "address_purpose": "LOCATION", "address_type": "DOM", "city": "FLOWOOD", "country_code": "US", "country_name": "United States", "fax_number": "601-939-3332", "postal_code": "392324405", "state": "MS", "telephone_number": "601-973-1507" }, { "address_1": "4301 LAKELAND DR", "address_purpose": "LOCATION", "address_type": "DOM", "city": "FLOWOOD", "country_code": "US", "country_name": "United States", "fax_number": "601-939-3332", "postal_code": "392328947", "state": "MS", "telephone_number": "601-939-7010" }, { "address_1": "102 LEXINGTON DR STE 100", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MADISON", "country_code": "US", "country_name": "United States", "fax_number": "601-973-1690", "postal_code": "391106952", "state": "MS", "telephone_number": "601-973-1688" }, { "address_1": "401 BAPTIST DR STE 306", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MADISON", "country_code": "US", "country_name": "United States", "fax_number": "601-607-7430", "postal_code": "391102012", "state": "MS", "telephone_number": "601-607-7204" }, { "address_1": "6250 OLD CANTON RD STE 130", "address_purpose": "LOCATION", "address_type": "DOM", "city": "JACKSON", "country_code": "US", "country_name": "United States", "fax_number": "601-977-6244", "postal_code": "392112946", "state": "MS", "telephone_number": "601-956-7280" }, { "address_1": "746 E FIFTEENTH ST", "address_purpose": "LOCATION", "address_type": "DOM", "city": "YAZOO CITY", "country_code": "US", "country_name": "United States", "fax_number": "601-746-0967", "postal_code": "391942706", "state": "MS", "telephone_number": "601-746-4032" } ], "taxonomies": [ { "code": "207Q00000X", "desc": "Family Medicine", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207RC0000X", "desc": "Internal Medicine, Cardiovascular Disease", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207RE0101X", "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207RP1001X", "desc": "Internal Medicine, Pulmonary Disease", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207T00000X", "desc": "Neurological Surgery", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207V00000X", "desc": "Obstetrics & Gynecology", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207VX0201X", "desc": "Obstetrics & Gynecology, Gynecologic Oncology", "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": "208000000X", "desc": "Pediatrics", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "2084N0400X", "desc": "Psychiatry & Neurology, Neurology", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "208G00000X", "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "225100000X", "desc": "Physical Therapist", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "225X00000X", "desc": "Occupational Therapist", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207R00000X", "desc": "Internal Medicine", "license": null, "primary": true, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" } ] }, { "addresses": [ { "address_1": "1331 UNION AVE STE 1008", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-620-5500", "postal_code": "381047567", "state": "TN", "telephone_number": "901-881-3554" }, { "address_1": "1331 UNION AVE STE 1008", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-620-5500", "postal_code": "381047567", "state": "TN", "telephone_number": "901-881-3554" } ], "basic": { "authorized_official_credential": "M.D.", "authorized_official_first_name": "VLADIMIR", "authorized_official_last_name": "CHACHANIDZE", "authorized_official_name_prefix": "Dr.", "authorized_official_name_suffix": "--", "authorized_official_telephone_number": "9018813554", "authorized_official_title_or_position": "Partner", "certification_date": "2023-04-18", "enumeration_date": "2007-01-18", "last_updated": "2023-04-18", "organization_name": "MEMPHIS INFECTIOUS DISEASES CONSULTANTS, PLLC", "organizational_subpart": "NO", "status": "A" }, "created_epoch": "1169137139000", "endpoints": [], "enumeration_type": "NPI-2", "identifiers": [], "last_updated_epoch": "1681832253000", "number": "1962554840", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": null, "primary": true, "state": null, "taxonomy_group": "193400000X - Single Specialty Group" } ] }, { "addresses": [ { "address_1": "6029 WALNUT GROVE RD STE 209", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-821-9987", "postal_code": "381202112", "state": "TN", "telephone_number": "901-681-0778" }, { "address_1": "6029 WALNUT GROVE RD STE 209", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-821-9987", "postal_code": "381202112", "state": "TN", "telephone_number": "901-681-0778" } ], "basic": { "authorized_official_credential": "MD", "authorized_official_first_name": "MANOJ", "authorized_official_last_name": "JAIN", "authorized_official_middle_name": "K", "authorized_official_name_prefix": "--", "authorized_official_name_suffix": "--", "authorized_official_telephone_number": "9016810778", "authorized_official_title_or_position": "President", "certification_date": "2023-01-24", "enumeration_date": "2006-06-25", "last_updated": "2023-01-24", "organization_name": "MID-SOUTH INFECTIOUS DISEASE ASSOCIATES, PLLC", "organizational_subpart": "NO", "status": "A" }, "created_epoch": "1151213291000", "endpoints": [], "enumeration_type": "NPI-2", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "009015743", "issuer": null, "state": "MS" }, { "code": "05", "desc": "MEDICAID", "identifier": "3723463", "issuer": null, "state": "TN" } ], "last_updated_epoch": "1674573858000", "number": "1245266733", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "md0000026445", "primary": true, "state": "TN", "taxonomy_group": "193200000X - Multi-Specialty Group" } ] }, { "addresses": [ { "address_1": "5316 W MAXIMA CV", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "postal_code": "381201562", "state": "TN" }, { "address_1": "116 N PAULINE ST", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "postal_code": "381041005", "state": "TN", "telephone_number": "901-523-8990" } ], "basic": { "certification_date": "2025-10-28", "enumeration_date": "2018-06-28", "first_name": "ANNA", "last_name": "MITCHELL", "last_updated": "2025-10-28", "middle_name": "BIRG", "sex": "F", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1530217998000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [], "last_updated_epoch": "1761677403000", "number": "1497240733", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "1835I0206X", "desc": "Pharmacist, Infectious Diseases", "license": "42111", "primary": true, "state": "TN", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "PO BOX 771684", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-295-5101", "postal_code": "381771684", "state": "TN", "telephone_number": "901-295-5100" }, { "address_1": "1068 CRESHAVEN RD STE 501", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-295-5101", "postal_code": "381190800", "state": "TN", "telephone_number": "901-295-5100" } ], "basic": { "certification_date": "2026-05-05", "credential": "M.D.", "enumeration_date": "2014-05-16", "first_name": "DANIEL", "last_name": "MURRELL", "last_updated": "2026-05-05", "middle_name": "SALLIS", "name_prefix": "Dr.", "sex": "M", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1400223940000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [], "last_updated_epoch": "1777986334000", "number": "1477964039", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "62426", "primary": true, "state": "TN", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "10350 HALIGUS RD STE 200D", "address_purpose": "LOCATION", "address_type": "DOM", "city": "HUNTLEY", "country_code": "US", "country_name": "United States", "fax_number": "847-802-7275", "postal_code": "601429545", "state": "IL", "telephone_number": "847-802-7270" }, { "address_1": "10350 HALIGUS RD STE 200D", "address_purpose": "MAILING", "address_type": "DOM", "city": "HUNTLEY", "country_code": "US", "country_name": "United States", "fax_number": "847-802-7275", "postal_code": "601429545", "state": "IL", "telephone_number": "847-802-7270" } ], "basic": { "certification_date": "2025-05-08", "credential": "MD", "enumeration_date": "2010-04-14", "first_name": "ALLISON", "last_name": "NAZINITSKY", "last_updated": "2025-05-08", "middle_name": "L", "sex": "F", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1271256491000", "endpoints": [ { "address_1": "2709 N Hudson Ave", "address_type": "DOM", "affiliation": "N", "city": "Oklahoma City", "contentTypeDescription": "", "country_code": "US", "country_name": "United States", "endpoint": "Anazinit@gmail.com", "endpointType": "OTHERS", "endpointTypeDescription": "Other URL", "postal_code": "731033028", "state": "OK", "use": "DIRECT", "useDescription": "Direct" } ], "enumeration_type": "NPI-1", "identifiers": [], "last_updated_epoch": "1746735280000", "number": "1922324011", "other_names": [], "practiceLocations": [ { "address_1": "4309 W MEDICAL CENTER DR STE B201", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MCHENRY", "country_code": "US", "country_name": "United States", "fax_number": "847-802-7275", "postal_code": "600508417", "state": "IL", "telephone_number": "847-802-7280" }, { "address_1": "880 MADISON AVE", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "postal_code": "381033409", "state": "TN", "telephone_number": "901-545-6969" } ], "taxonomies": [ { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "MD60792183", "primary": false, "state": "WA", "taxonomy_group": "" }, { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "Md2019-0854", "primary": false, "state": "NM", "taxonomy_group": "" }, { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "70877", "primary": false, "state": "TN", "taxonomy_group": "" }, { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "73930-20", "primary": false, "state": "WI", "taxonomy_group": "" }, { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "036151756", "primary": true, "state": "IL", "taxonomy_group": "" }, { "code": "207R00000X", "desc": "Internal Medicine", "license": "31545", "primary": false, "state": "OK", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "6029 WALNUT GROVE RD STE C002", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-685-3499", "postal_code": "381202112", "state": "TN", "telephone_number": "901-685-3490" }, { "address_1": "6799 GREAT OAKS RD STE 250", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-685-3499", "postal_code": "381382584", "state": "TN", "telephone_number": "901-685-3490" } ], "basic": { "certification_date": "2020-11-19", "credential": "MD", "enumeration_date": "2006-04-18", "first_name": "KRISTIE", "last_name": "NOWAK", "last_updated": "2020-11-19", "sex": "F", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1145397027000", "endpoints": [ { "address_1": "3314 Patriot Ct", "address_type": "DOM", "affiliation": "N", "city": "Herrin", "contentTypeDescription": "", "country_code": "US", "country_name": "United States", "endpoint": "knowak48243@sih.direct-ci.com", "endpointType": "DIRECT", "endpointTypeDescription": "Direct Messaging Address", "postal_code": "629483782", "state": "IL", "useDescription": "" } ], "enumeration_type": "NPI-1", "identifiers": [], "last_updated_epoch": "1605801176000", "number": "1275598781", "other_names": [], "practiceLocations": [ { "address_1": "3314 PATRIOT CT", "address_purpose": "LOCATION", "address_type": "DOM", "city": "HERRIN", "country_code": "US", "country_name": "United States", "fax_number": "618-993-1595", "postal_code": "629483782", "state": "IL", "telephone_number": "618-993-1591" } ], "taxonomies": [ { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "036153201", "primary": false, "state": "IL", "taxonomy_group": "" }, { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "56938", "primary": true, "state": "TN", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "6029 WALNUT GROVE RD STE C002", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "postal_code": "381202112", "state": "TN", "telephone_number": "901-685-3490" }, { "address_1": "6029 WALNUT GROVE RD # C002", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-685-3499", "postal_code": "381202112", "state": "TN", "telephone_number": "901-685-3490" } ], "basic": { "certification_date": "2020-11-23", "credential": "M.B.B.S", "enumeration_date": "2015-07-17", "first_name": "CHIEMEZIEM", "last_name": "NWANYANWU", "last_updated": "2020-11-23", "sex": "F", "sole_proprietor": "YES", "status": "A" }, "created_epoch": "1437162380000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [], "last_updated_epoch": "1606164486000", "number": "1477937548", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "61802", "primary": true, "state": "TN", "taxonomy_group": "193400000X - Single Specialty Group" } ] }, { "addresses": [ { "address_1": "6029 WALNUT GROVE RD # C002", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-685-3499", "postal_code": "381202112", "state": "TN", "telephone_number": "901-685-3490" }, { "address_1": "6799 GREAT OAKS RD STE 250", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-685-3499", "postal_code": "381382584", "state": "TN", "telephone_number": "901-685-3490" } ], "basic": { "credential": "M.D.", "enumeration_date": "2006-03-02", "first_name": "IMAD", "last_name": "OMER", "last_updated": "2019-01-03", "sex": "M", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1141315044000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "04026851", "issuer": null, "state": "MS" }, { "code": "05", "desc": "MEDICAID", "identifier": "09016197", "issuer": null, "state": "MS" }, { "code": "05", "desc": "MEDICAID", "identifier": "3721649", "issuer": null, "state": "TN" }, { "code": "05", "desc": "MEDICAID", "identifier": "3876262", "issuer": null, "state": "TN" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "4043619", "issuer": "BCBST", "state": "TN" } ], "last_updated_epoch": "1546526099000", "number": "1356318059", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "MD36446", "primary": true, "state": "TN", "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": "38104", "state": "TN", "telephone_number": "901-523-8990" }, { "address_1": "2901 CORAL HILLS DR", "address_2": "SUITE 220", "address_purpose": "MAILING", "address_type": "DOM", "city": "CORAL SPRINGS", "country_code": "US", "country_name": "United States", "fax_number": "954-346-8315", "postal_code": "330654146", "state": "FL", "telephone_number": "954-345-0404" } ], "basic": { "certification_date": "2020-04-17", "credential": "M.D.", "enumeration_date": "2010-06-20", "first_name": "TEJAL", "last_name": "PATEL", "last_updated": "2020-04-17", "middle_name": "MAYUR", "name_prefix": "Dr.", "sex": "F", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1277060049000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [], "last_updated_epoch": "1587139326000", "number": "1891016283", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "ME124784", "primary": true, "state": "FL", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "5200 PARK AVE STE 202", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "postal_code": "381193505", "state": "TN", "telephone_number": "901-485-4516" }, { "address_1": "5200 PARK AVE STE 202", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "postal_code": "381193505", "state": "TN", "telephone_number": "901-676-2026" } ], "basic": { "certification_date": "2024-03-06", "credential": "PharmD", "enumeration_date": "2024-03-05", "first_name": "NICHOLSON", "last_name": "PERKINS", "last_updated": "2024-03-06", "name_prefix": "Dr.", "name_suffix": "III", "sex": "M", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1709671505000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [], "last_updated_epoch": "1709761617000", "number": "1134986128", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "183500000X", "desc": "Pharmacist", "license": "5302414323", "primary": false, "state": "MI", "taxonomy_group": "" }, { "code": "183500000X", "desc": "Pharmacist", "license": "T-101429", "primary": false, "state": "MS", "taxonomy_group": "" }, { "code": "183500000X", "desc": "Pharmacist", "license": "46632", "primary": false, "state": "TN", "taxonomy_group": "" }, { "code": "1835P0018X", "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist", "license": "46632", "primary": false, "state": "TN", "taxonomy_group": "" }, { "code": "208U00000X", "desc": "Clinical Pharmacology", "license": "46632", "primary": false, "state": "TN", "taxonomy_group": "" }, { "code": "1835I0206X", "desc": "Pharmacist, Infectious Diseases", "license": "46632", "primary": true, "state": "TN", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "6029 WALNUT GROVE RD STE 209", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-821-9987", "postal_code": "381202112", "state": "TN", "telephone_number": "901-681-0778" }, { "address_1": "6027 WALNUT GROVE RD", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-821-9987", "postal_code": "381202145", "state": "TN", "telephone_number": "901-681-0778" } ], "basic": { "certification_date": "2023-01-24", "credential": "M.D.", "enumeration_date": "2008-12-01", "first_name": "HIREN", "last_name": "POKHARNA", "last_updated": "2023-01-24", "middle_name": "SAMPATRAJ", "name_prefix": "Dr.", "sex": "M", "sole_proprietor": "YES", "status": "A" }, "created_epoch": "1228165653000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "004773706", "issuer": null, "state": "MS" } ], "last_updated_epoch": "1674574385000", "number": "1114172376", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "282N00000X", "desc": "General Acute Care Hospital", "license": null, "primary": false, "state": null, "taxonomy_group": "" }, { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "MD0000047094", "primary": true, "state": "TN", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "3012 E COMMERCIAL BLVD", "address_purpose": "LOCATION", "address_type": "DOM", "city": "FORT LAUDERDALE", "country_code": "US", "country_name": "United States", "fax_number": "954-776-9993", "postal_code": "333084356", "state": "FL", "telephone_number": "954-776-9992" }, { "address_1": "PO BOX 1000 DEPT 394", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "941-404-1760", "postal_code": "381480001", "state": "TN", "telephone_number": "941-300-4440" } ], "basic": { "certification_date": "2025-04-04", "credential": "M.D.", "enumeration_date": "2005-06-27", "first_name": "STEPHEN", "last_name": "RENAE", "last_updated": "2025-04-04", "middle_name": "A.", "name_prefix": "Dr.", "sex": "M", "sole_proprietor": "YES", "status": "A" }, "created_epoch": "1119887167000", "endpoints": [ { "address_1": "3012 E Commercial Blvd", "address_type": "DOM", "affiliation": "N", "city": "Fort Lauderdale", "contentTypeDescription": "", "country_code": "US", "country_name": "United States", "endpoint": "DrRenae@direct.practicefusion.com", "endpointType": "DIRECT", "endpointTypeDescription": "Direct Messaging Address", "postal_code": "333084356", "state": "FL", "use": "DIRECT", "useDescription": "Direct" } ], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "372037300", "issuer": null, "state": "FL" } ], "last_updated_epoch": "1743783619000", "number": "1841296670", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "261Q00000X", "desc": "Clinic/Center", "license": "ME0063353", "primary": false, "state": "FL", "taxonomy_group": "" }, { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "ME0063353", "primary": true, "state": "FL", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "4700 BAYOU BLVD STE 6", "address_purpose": "LOCATION", "address_type": "DOM", "city": "PENSACOLA", "country_code": "US", "country_name": "United States", "fax_number": "850-494-9843", "postal_code": "325031901", "state": "FL", "telephone_number": "850-477-9253" }, { "address_1": "4700 BAYOU BLVD STE 6", "address_purpose": "MAILING", "address_type": "DOM", "city": "PENSACOLA", "country_code": "US", "country_name": "United States", "fax_number": "850-494-9843", "postal_code": "325031901", "state": "FL", "telephone_number": "850-477-9253" } ], "basic": { "certification_date": "2022-10-14", "credential": "M.D.", "enumeration_date": "2006-07-29", "first_name": "ALEJANDRO", "last_name": "RESTREPO", "last_updated": "2022-10-14", "sex": "M", "sole_proprietor": "YES", "status": "A" }, "created_epoch": "1154202657000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [], "last_updated_epoch": "1665760539000", "number": "1457366502", "other_names": [], "practiceLocations": [ { "address_1": "1 BAYLOR PLZ # 286N1319", "address_purpose": "LOCATION", "address_type": "DOM", "city": "HOUSTON", "country_code": "US", "country_name": "United States", "fax_number": "713-798-0171", "postal_code": "770303411", "state": "TX", "telephone_number": "713-798-2900" }, { "address_1": "956 COURT AVE SUITE H314A", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "postal_code": "38163", "state": "TN", "telephone_number": "901-448-5737" }, { "address_1": "500 W MEDICAL CENTER BLVD", "address_purpose": "LOCATION", "address_type": "DOM", "city": "WEBSTER", "country_code": "US", "country_name": "United States", "postal_code": "775984220", "state": "TX", "telephone_number": "281-332-2511" } ], "taxonomies": [ { "code": "207RC0200X", "desc": "Internal Medicine, Critical Care Medicine", "license": "P4803", "primary": false, "state": "TX", "taxonomy_group": "" }, { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "P4803", "primary": false, "state": "TX", "taxonomy_group": "" }, { "code": "207RC0200X", "desc": "Internal Medicine, Critical Care Medicine", "license": "ME157716", "primary": true, "state": "FL", "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": "2006-05-02", "first_name": "SUSIE", "last_name": "SARGENT", "last_updated": "2007-07-08", "middle_name": "J", "name_prefix": "Dr.", "name_suffix": "--", "sex": "F", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1146587389000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "3027080", "issuer": null, "state": "TN" } ], "last_updated_epoch": "1183947785000", "number": "1467410324", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "15301", "primary": true, "state": "TN", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "1301 W COLONIAL DR", "address_purpose": "LOCATION", "address_type": "DOM", "city": "ORLANDO", "country_code": "US", "country_name": "United States", "fax_number": "855-895-5749", "postal_code": "328047133", "state": "FL", "telephone_number": "407-246-1946" }, { "address_1": "PO BOX 1000 DEPT 394", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "941-404-1760", "postal_code": "381480001", "state": "TN", "telephone_number": "941-300-4440" } ], "basic": { "certification_date": "2024-09-04", "credential": "MD", "enumeration_date": "2006-02-22", "first_name": "VINCENZO", "last_name": "SCOTTO D'ANTUONO", "last_updated": "2024-09-04", "sex": "M", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1140633440000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "105879800", "issuer": null, "state": "FL" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "MB959", "issuer": "FL Medicare", "state": "FL" } ], "last_updated_epoch": "1725480735000", "number": "1811962855", "other_names": [], "practiceLocations": [ { "address_1": "1435 DUNN AVE STE 101", "address_purpose": "LOCATION", "address_type": "DOM", "city": "DAYTONA BEACH", "country_code": "US", "country_name": "United States", "postal_code": "321141434", "state": "FL", "telephone_number": "386-274-7651" }, { "address_1": "4615 PHILIPS HWY STE 3", "address_purpose": "LOCATION", "address_type": "DOM", "city": "JACKSONVILLE", "country_code": "US", "country_name": "United States", "postal_code": "322079541", "state": "FL", "telephone_number": "904-508-0710" } ], "taxonomies": [ { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "ME144729", "primary": true, "state": "FL", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "6029 WALNUT GROVE RD STE 209", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-821-9987", "postal_code": "381202112", "state": "TN", "telephone_number": "901-681-0778" }, { "address_1": "6029 WALNUT GROVE RD STE 209", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-821-9987", "postal_code": "381202112", "state": "TN", "telephone_number": "901-681-0778" } ], "basic": { "certification_date": "2025-08-12", "credential": "MD", "enumeration_date": "2020-05-07", "first_name": "ISHA", "last_name": "SHRIMANKER", "last_updated": "2025-08-12", "middle_name": "MAYUR", "name_prefix": "Ms.", "sex": "F", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1588884069000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [], "last_updated_epoch": "1755005845000", "number": "1558983072", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "72927", "primary": true, "state": "TN", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "PO BOX 1000 DEPT 394", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "954-776-9993", "postal_code": "381480001", "state": "TN", "telephone_number": "954-776-9992" }, { "address_1": "3012 E COMMERCIAL BLVD", "address_purpose": "LOCATION", "address_type": "DOM", "city": "FORT LAUDERDALE", "country_code": "US", "country_name": "United States", "fax_number": "954-776-9993", "postal_code": "333084356", "state": "FL", "telephone_number": "954-776-9992" } ], "basic": { "certification_date": "2025-03-19", "credential": "PA-C", "enumeration_date": "2014-08-25", "first_name": "HANNAH", "last_name": "SILVERMAN", "last_updated": "2025-04-01", "middle_name": "MAE", "sex": "F", "sole_proprietor": "YES", "status": "A" }, "created_epoch": "1408989267000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [], "last_updated_epoch": "1743529097000", "number": "1366842585", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "363A00000X", "desc": "Physician Assistant", "license": null, "primary": true, "state": null, "taxonomy_group": "" }, { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "PA9108289", "primary": false, "state": "FL", "taxonomy_group": "193400000X - Single Specialty Group" } ] }, { "addresses": [ { "address_1": "176 S BELLEVUE BLVD", "address_2": "SUITE 603", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-516-8249", "postal_code": "381043424", "state": "TN", "telephone_number": "901-516-8231" }, { "address_1": "176 S BELLEVUE BLVD", "address_2": "SUITE 603", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-516-8249", "postal_code": "381043424", "state": "TN", "telephone_number": "901-516-8231" } ], "basic": { "credential": "MD", "enumeration_date": "2005-06-08", "first_name": "BRYAN", "last_name": "SIMMONS", "last_updated": "2010-06-21", "middle_name": "PAUL", "name_prefix": "--", "name_suffix": "--", "sex": "M", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1118239425000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "3020692", "issuer": null, "state": "TN" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "E0615", "issuer": "AR License", "state": "AR" } ], "last_updated_epoch": "1277128832000", "number": "1619971637", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "MD 15503", "primary": true, "state": "TN", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "877 JEFFERSON AVE", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-545-7177", "postal_code": "381032807", "state": "TN", "telephone_number": "901-545-7100" }, { "address_1": "880 MADISON AVE", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-545-7177", "postal_code": "381033409", "state": "TN", "telephone_number": "901-545-6969" } ], "basic": { "credential": "M.D.", "enumeration_date": "2013-03-19", "first_name": "NATHAN", "last_name": "SUMMERS", "last_updated": "2019-06-03", "middle_name": "ALAN", "sex": "M", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1363728449000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [], "last_updated_epoch": "1559577116000", "number": "1649512468", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "59040", "primary": true, "state": "TN", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "5210 POPLAR AVE", "address_2": "SUITE 200", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "postal_code": "381193515", "state": "TN", "telephone_number": "901-685-3490" }, { "address_1": "5210 POPLAR AVE", "address_2": "SUITE 200", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "postal_code": "381193515", "state": "TN", "telephone_number": "901-685-3490" } ], "basic": { "authorized_official_credential": "MD", "authorized_official_first_name": "MICHAEL", "authorized_official_last_name": "THRELKELD", "authorized_official_middle_name": "G", "authorized_official_name_prefix": "--", "authorized_official_name_suffix": "--", "authorized_official_telephone_number": "9016853490", "authorized_official_title_or_position": "Partner", "enumeration_date": "2006-07-29", "last_updated": "2020-08-22", "organization_name": "THREDKELD THRELKELD AND OMER PLLC", "organizational_subpart": "NO", "status": "A" }, "created_epoch": "1154184730000", "endpoints": [], "enumeration_type": "NPI-2", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "09016197", "issuer": null, "state": "MS" }, { "code": "05", "desc": "MEDICAID", "identifier": "3721649", "issuer": null, "state": "TN" } ], "last_updated_epoch": "1598100723000", "number": "1073527305", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": null, "primary": true, "state": null, "taxonomy_group": "193400000X - Single Specialty Group" } ] }, { "addresses": [ { "address_1": "6029 WALNUT GROVE RD STE C002", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-685-3499", "postal_code": "381202112", "state": "TN", "telephone_number": "901-685-3490" }, { "address_1": "6799 GREAT OAKS RD STE 250", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-685-3499", "postal_code": "381382584", "state": "TN", "telephone_number": "901-685-3490" } ], "basic": { "credential": "M.D.", "enumeration_date": "2006-03-06", "first_name": "MICHAEL", "last_name": "THRELKELD", "last_updated": "2019-01-02", "middle_name": "G", "sex": "M", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1141683023000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "00017990", "issuer": null, "state": "MS" }, { "code": "05", "desc": "MEDICAID", "identifier": "155434001", "issuer": null, "state": "AR" }, { "code": "05", "desc": "MEDICAID", "identifier": "3042007", "issuer": null, "state": "TN" }, { "code": "05", "desc": "MEDICAID", "identifier": "3721649", "issuer": null, "state": "TN" } ], "last_updated_epoch": "1546458880000", "number": "1356318661", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "MD15116", "primary": true, "state": "TN", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "6029 WALNUT GROVE RD STE C002", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-685-3499", "postal_code": "381202112", "state": "TN", "telephone_number": "901-685-3490" }, { "address_1": "6799 GREAT OAKS RD STE 250", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-685-3499", "postal_code": "381382584", "state": "TN", "telephone_number": "901-685-3490" } ], "basic": { "credential": "M.D.", "enumeration_date": "2006-03-06", "first_name": "STEPHEN", "last_name": "THRELKELD", "last_updated": "2019-01-02", "middle_name": "C", "sex": "M", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1141689492000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "00124291", "issuer": null, "state": "MS" }, { "code": "05", "desc": "MEDICAID", "identifier": "09016197", "issuer": null, "state": "MS" }, { "code": "05", "desc": "MEDICAID", "identifier": "115434001", "issuer": null, "state": "AR" }, { "code": "01", "desc": "Other (non-Medicare)", "identifier": "3155614", "issuer": "BCBST", "state": "TN" }, { "code": "05", "desc": "MEDICAID", "identifier": "3721649", "issuer": null, "state": "TN" }, { "code": "05", "desc": "MEDICAID", "identifier": "3811529", "issuer": null, "state": "TN" } ], "last_updated_epoch": "1546456668000", "number": "1578530895", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "MD28793", "primary": true, "state": "TN", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "1068 CRESTHAVEN RD", "address_2": "SUITE 250", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-864-3499", "postal_code": "381190800", "state": "TN", "telephone_number": "901-865-3490" }, { "address_1": "1068 CRESTHAVEN RD", "address_2": "SUITE 250", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-864-3499", "postal_code": "381190800", "state": "TN", "telephone_number": "901-865-3490" } ], "basic": { "authorized_official_credential": "M.D.", "authorized_official_first_name": "MICHAEL", "authorized_official_last_name": "THRELKELD", "authorized_official_middle_name": "G", "authorized_official_name_prefix": "--", "authorized_official_name_suffix": "--", "authorized_official_telephone_number": "9016853490", "authorized_official_title_or_position": "Owner Partner", "enumeration_date": "2007-02-19", "last_updated": "2011-07-06", "organization_name": "THRELKELD THRELKELD AND OMER PLLC", "organizational_subpart": "NO", "status": "A" }, "created_epoch": "1171916978000", "endpoints": [], "enumeration_type": "NPI-2", "identifiers": [], "last_updated_epoch": "1309966433000", "number": "1982748133", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": null, "primary": true, "state": null, "taxonomy_group": "193400000X - Single Specialty Group" } ] }, { "addresses": [ { "address_1": "1211 UNION AVE STE 700", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-937-6696", "postal_code": "381046600", "state": "TN", "telephone_number": "901-478-0954" }, { "address_1": "1325 EASTMORELAND AVE STE 310", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-266-6425", "postal_code": "381047544", "state": "TN", "telephone_number": "901-758-7970" } ], "basic": { "authorized_official_first_name": "TABATHA", "authorized_official_last_name": "PERRY", "authorized_official_telephone_number": "9014780954", "authorized_official_title_or_position": "Manager, Provider Enrollment", "certification_date": "2025-10-20", "enumeration_date": "2012-05-03", "last_updated": "2025-10-20", "organization_name": "UT METHODIST PHYSICIANS LLC", "organizational_subpart": "NO", "status": "A" }, "created_epoch": "1336079790000", "endpoints": [], "enumeration_type": "NPI-2", "identifiers": [], "last_updated_epoch": "1760993051000", "number": "1427317908", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "208600000X", "desc": "Surgery", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "2086S0129X", "desc": null, "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207RT0003X", "desc": "Internal Medicine, Transplant Hepatology", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207RR0500X", "desc": "Internal Medicine, Rheumatology", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207RE0101X", "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "204F00000X", "desc": "Transplant Surgery", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "2086X0206X", "desc": "Surgery, Surgical Oncology", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "2084N0400X", "desc": "Psychiatry & Neurology, Neurology", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207RG0100X", "desc": "Internal Medicine, Gastroenterology", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207RP1001X", "desc": "Internal Medicine, Pulmonary Disease", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "208G00000X", "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)", "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": "207RN0300X", "desc": "Internal Medicine, Nephrology", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207R00000X", "desc": "Internal Medicine", "license": null, "primary": true, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" } ] }, { "addresses": [ { "address_1": "1420 ROCKY RIDGE DR STE 300", "address_purpose": "LOCATION", "address_type": "DOM", "city": "ROSEVILLE", "country_code": "US", "country_name": "United States", "postal_code": "956612835", "state": "CA", "telephone_number": "916-865-4668" }, { "address_1": "1420 E ROSEVILLE PKWY STE 140", "address_purpose": "MAILING", "address_type": "DOM", "city": "ROSEVILLE", "country_code": "US", "country_name": "United States", "postal_code": "956613080", "state": "CA", "telephone_number": "916-865-4668" } ], "basic": { "authorized_official_credential": "MD", "authorized_official_first_name": "SHAJI", "authorized_official_last_name": "SKARIA", "authorized_official_middle_name": "D", "authorized_official_name_prefix": "Dr.", "authorized_official_telephone_number": "6318305438", "authorized_official_title_or_position": "Owner", "certification_date": "2023-07-14", "enumeration_date": "2022-09-29", "last_updated": "2023-07-14", "organization_name": "VEEONE MEDICAL GROUP PA", "organizational_subpart": "NO", "status": "A" }, "created_epoch": "1664482174000", "endpoints": [], "enumeration_type": "NPI-2", "identifiers": [], "last_updated_epoch": "1689351295000", "number": "1265156558", "other_names": [], "practiceLocations": [ { "address_1": "6000 POPLAR AVENUE", "address_2": "SUITE 250 - #2015", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "postal_code": "38119", "state": "TN", "telephone_number": "916-865-4668" }, { "address_1": "3516 PAR RD", "address_purpose": "LOCATION", "address_type": "DOM", "city": "SEBRING", "country_code": "US", "country_name": "United States", "postal_code": "338721225", "state": "FL", "telephone_number": "916-865-4668" }, { "address_1": "500 KNIGHTS RUN AVE UNIT 2014", "address_purpose": "LOCATION", "address_type": "DOM", "city": "TAMPA", "country_code": "US", "country_name": "United States", "postal_code": "336026020", "state": "FL", "telephone_number": "916-865-4668" }, { "address_1": "501 NE 94TH ST", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MIAMI SHORES", "country_code": "US", "country_name": "United States", "postal_code": "331382847", "state": "FL", "telephone_number": "916-865-4668" }, { "address_1": "3031 OSPREY CIR", "address_purpose": "LOCATION", "address_type": "DOM", "city": "PANAMA CITY", "country_code": "US", "country_name": "United States", "postal_code": "324050200", "state": "FL", "telephone_number": "916-865-4668" } ], "taxonomies": [ { "code": "207R00000X", "desc": "Internal Medicine", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207RE0101X", "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207RI0011X", "desc": "Internal Medicine, Interventional Cardiology", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207RN0300X", "desc": "Internal Medicine, Nephrology", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207RP1001X", "desc": "Internal Medicine, Pulmonary Disease", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207RR0500X", "desc": "Internal Medicine, Rheumatology", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207T00000X", "desc": "Neurological Surgery", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "2084N0400X", "desc": "Psychiatry & Neurology, Neurology", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "208M00000X", "desc": "Hospitalist", "license": null, "primary": false, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" }, { "code": "207RC0200X", "desc": "Internal Medicine, Critical Care Medicine", "license": null, "primary": true, "state": null, "taxonomy_group": "193200000X - Multi-Specialty 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": "2006-05-01", "first_name": "ELLEN", "last_name": "WHITNACK", "last_updated": "2007-07-08", "name_prefix": "Dr.", "name_suffix": "--", "sex": "F", "sole_proprietor": "NO", "status": "A" }, "created_epoch": "1146527580000", "endpoints": [], "enumeration_type": "NPI-1", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "3170485", "issuer": null, "state": "TN" } ], "last_updated_epoch": "1183947785000", "number": "1417915497", "other_names": [], "practiceLocations": [], "taxonomies": [ { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": "10572", "primary": true, "state": "TN", "taxonomy_group": "" } ] }, { "addresses": [ { "address_1": "PO BOX 771684", "address_purpose": "MAILING", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-295-5101", "postal_code": "381771684", "state": "TN", "telephone_number": "901-295-5100" }, { "address_1": "1068 CRESHAVEN RD STE 501", "address_purpose": "LOCATION", "address_type": "DOM", "city": "MEMPHIS", "country_code": "US", "country_name": "United States", "fax_number": "901-881-5944", "postal_code": "381190800", "state": "TN", "telephone_number": "901-450-7470" } ], "basic": { "authorized_official_credential": "MD", "authorized_official_first_name": "DANIEL", "authorized_official_last_name": "MURRELL", "authorized_official_middle_name": "SALLIS", "authorized_official_name_prefix": "Dr.", "authorized_official_telephone_number": "9012955100", "authorized_official_title_or_position": "Physician", "certification_date": "2026-05-05", "enumeration_date": "2023-04-17", "last_updated": "2026-05-05", "organization_name": "WHOLLY WOUNDS, PLLC", "organizational_subpart": "NO", "status": "A" }, "created_epoch": "1681742928000", "endpoints": [], "enumeration_type": "NPI-2", "identifiers": [ { "code": "05", "desc": "MEDICAID", "identifier": "1477964039", "issuer": null, "state": "TN" } ], "last_updated_epoch": "1777992336000", "number": "1578259016", "other_names": [ { "code": "5", "organization_name": "MIDSOUTH WOUND SOLUTIONS", "type": "Other Name" } ], "practiceLocations": [], "taxonomies": [ { "code": "207RI0200X", "desc": "Internal Medicine, Infectious Disease", "license": null, "primary": true, "state": null, "taxonomy_group": "193200000X - Multi-Specialty Group" } ] } ] }