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TANJALA TRINETTE GIPSON MD NPI 1528113602


NPI Information

NPI: 1528113602
Provider Name: TANJALA TRINETTE GIPSON, MD
Classification: Pediatrics - 2080P0008X
Entity Type: Individual

Specialization: Neurodevelopmental Disabilities

PECOS Registration: Yes

Address:
51 N DUNLAP ST STE 400
MEMPHIS, TN
ZIP 38105
Phone: (901) 287-7337
Get Directions

Tanjala Trinette Gipson, MD is a neurodevelopmental disabilities pediatrics in Memphis, TN with 20 years of experience. The provider is a pediatrician who specializes in the treatment of individuals with developmental delays and learning disorders associated with cerebral palsy, spina bifida, autism, and other chronic neurologic conditions. Tanjala Trinette Gipson, MD NPI is 1528113602. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS
Graduation Year:2004

The provider's business location address is:

51 N DUNLAP ST STE 400
MEMPHIS, TN
ZIP 38105-625
Phone: (901) 287-7337
Fax: (901) 387-5143

The NPI 1528113602 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/25/2007 and was last updated on 4/14/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12080P0008XPediatricsNeurodevelopmental Disabilities54122TENNESSEEYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1PENDINGMEDICAIDTENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.