MEMPHIS & SHELBY COUNTY PEDIATRIC GROUP NPI 1487797536

NPI Information

  • NPI: 1487797536
  • Provider Name: MEMPHIS & SHELBY COUNTY PEDIATRIC GROUP
  • Classification: Pediatrics - 2080A0000X
  • Specialization: Adolescent Medicine
  • Entity Type: Organization
  • CLIA Number: 44D0956888
  • Address: 6479 WINCHESTER RD
    SUITE 118
    MEMPHIS, TN
    ZIP 38115
  • Phone: (901) 866-2133

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NPI Details

MEMPHIS & SHELBY COUNTY PEDIATRIC GROUP is an adolescent medicine pediatrics in Memphis, TN. The provider is a pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. MEMPHIS & SHELBY COUNTY PEDIATRIC GROUP NPI is 1487797536. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

6479 WINCHESTER RD
SUITE 118
MEMPHIS, TN
ZIP 38115-240
Phone: (901) 866-2133
Fax: (901) 866-2136

The provider's authorized official is Katherine Carter .
The authorized official title is Billing Supervisor and has the following contact phone number (901) 396-8366.

The CLIA number assigned to this NPI record is 44D0956888 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/15/2007 and was last updated on 8/22/2020.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12080A0000XPediatricsAdolescent MedicineYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1117847OTHERTENNESSEEUNISON
25598466OTHERTENNESSEEAETNA

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: 11/21/2025

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