DR. KENNETH MICHAEL MACURIK (NPI# 1053446757) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053446757 |
| Entity Type | Individual |
| Full Name | DR. KENNETH MICHAEL MACURIK |
| Credential | PH.D. |
| Practice Address |
3543 Philwood Ave Memphis TN 38122-4557 |
| Practice Telephone | 9017457315 |
| Practice Fax Number | 9017457251 |
| Mailing Telephone | 9017457315 |
| Mailing Fax Number | 9017457251 |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TM1800X |
Psychologist Specialization: Mental Retardation & Developmental Disabilities |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | BEHAVIOR CERTIFICATION | 1-06-2847 | 01 |
| Street Address |
3543 PHILWOOD AVE |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38122-4557 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235665746 | Casey Grier Smith | Student in an Organized Health Care Education/Training Program | 3628 Autumn Ave, Memphis, TN 38122 | 2017-05-03 |
| 1730463076 | H. George Wood Jr. | Pharmacist | 3502 Summer Avenue, Memphis, TN 38122 | 2011-10-05 |
| 1093932766 | Midtown Mental Center | Point of Service | 790 Bartlett Rd #28, Memphis, TN 38122 | 2007-04-20 |
| 1508988254 | Mahboubeh Sayed Taghavi | Dentist | 5126 Summer Ave Suite 101, Memphis, TN 38122 | 2007-04-04 |
| 1700977014 | Christopher M Nunnelee | Dentist | 752 National St, Memphis, TN 38122 | 2006-09-28 |
| 1508958398 | Pirani & Nunnelee Dds Plc | Dentist | 752 National St, Memphis, TN 38122 | 2006-09-29 |
| 1417048729 | Carlo B Pirani Jr. | Dentist | 752 National St, Memphis, TN 38122 | 2006-09-28 |
| 1689708067 | Michele Gaur | Speech-Language Pathologist | 940 Dwyer St, Memphis, TN 38122-1920 | 2007-03-15 |
| 1497855522 | Mary Pat Corrigan Jobes | Physical Therapist | 977 Giaroli St, Memphis, TN 38122-1934 | 2006-09-25 |
| 1649717588 | Rebecca Ruth Cox | Advanced Practice Midwife | 3638 Macon Rd, C/o The Morning Center, Memphis, TN 38122-2209 | 2017-01-30 |
| Find all providers in zip 38122 | ||||
| Taxonomy Code | 103TM1800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Mental Retardation & Developmental Disabilities |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841346095 | Maurice Butler Jr. | Psychologist | 4942 Noel Mission Dr, Memphis, TN 38125-4783 | 2007-01-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609351766 | Superior Residential Solutions, LLC | Psychologist | 5225 Rocky Ford Ln, Arlington, TN 38002-4833 | 2018-09-25 |
| 1265681936 | Paul R. Malanga | Psychologist | 9395 Garden Woods Dr, Cordova, TN 38016-4729 | 2008-09-17 |
| 1194999615 | Nicole Marie Bichelman | Psychologist | 862 Winterfields Dr., Cordova, TN 38018-7965 | 2008-04-15 |
| 1700071651 | Timothy Cripps | Psychologist | 1778 Penshurst Dr, Collierville, TN 38017-9104 | 2007-09-12 |
| 1770776858 | Carrie Peacock | Psychologist | 1155 Cully Rd, Cordova, TN 38018-8502 | 2007-08-22 |
| 1801007984 | David H. Craig | Psychologist | 202 Sunnymeade Dr, Columbia, TN 38401-5225 | 2007-05-24 |
| 1689796500 | Liming Zhou | Psychologist | 6117 Lamb Woods Dr, Bartlett, TN 38135-9256 | 2007-04-03 |
| 1629108642 | George Elliott Zukotynski | Psychologist | 3229 Nolen Ln, Franklin, TN 37064-6222 | 2007-03-07 |
| 1316988579 | Michael E Rohr | Psychologist | 550 Lazenby Dr, Somerville, TN 38068-5030 | 2006-06-09 |
| 1396200424 | Gary Brown | Psychologist | 302 Broadway St, Martin, TN 38237-2455 | 2019-02-02 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.