SHEA CLINIC NPI 1760447015

NPI Information

NPI: 1760447015
Provider Name: SHEA CLINIC

Doing Business As: SHEA CLINIC, ASC

Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
6133 POPLAR PIKE
MEMPHIS, TN
ZIP 38119
Phone: (901) 761-9720
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SHEA CLINIC is an ambulatory surgical clinic center in Memphis, TN. SHEA CLINIC NPI is 1760447015. The provider is registered as an organization entity type.
The provider Is Doing Business As Shea Clinic, Asc.

The provider's business location address is:

6133 POPLAR PIKE
MEMPHIS, TN
ZIP 38119-707
Phone: (901) 761-9720
Fax: (901) 683-8440

The provider's authorized official is John R Gross .
The authorized official title is Administrator and has the following contact phone number (901) 761-9720.

The enumeration date for this NPI number is 4/19/2006 and was last updated on 10/21/2010.

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
1	261QA1903X	Clinic/Center	Ambulatory Surgical	0000000050	TENNESSEE	Yes

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
1	3287130	MEDICARE ID-TYPE UNSPECIFIED	TENNESSEE	GROUP MEDICARE NUMBER
2	490000678	OTHER	TENNESSEE	RAILROAD MEDICARE

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: 5/5/2024

NPI Synchronization or Removal

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