THE FAMILY PHYSICIAN GROUP PC (NPI# 1073539938) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073539938 |
| Entity Type | Organization |
| Organization Name | THE FAMILY PHYSICIAN GROUP PC |
| Other Organization Name | HERMAN WESLEY DYKES JR DO |
| Practice Address |
7685 Winchester Rd Ste 101 Memphis TN 38125-2202 |
| Mailing Address |
2859 Van Leer Dr Memphis TN 38133-4935 |
| Practice Telephone | 9012609300 |
| Practice Fax Number | 9017515541 |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2007-11-19 |
| Authorized Official Name | ANGIE QUALLS (ADMINISTRATOR) |
| Authorized Official Telephone | 9017515514 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | 3926223 | TN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER | 4439154 | 01 | |
| OTHER ID NUMBER-COMMERCIAL NUMBER | 4439154 | 01 |
| Other Name | Type Code |
|---|---|
| HERMAN WESLEY DYKES JR DO | Doing Business As Name - Organization |
| Street Address |
7685 WINCHESTER RD STE 101 |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38125-2202 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144798448 | Ronald Penn Jr. | Day Training, Developmentally Disabled Services | 4751 Harvest Park Dr., Memphis, TN 38125 | 2018-11-05 |
| 1417458944 | Crestwyn Health Group, LLC | Psychiatry & Neurology | 9485 Crestwyn Hills Cv, Memphis, TN 38125 | 2018-02-21 |
| 1982121323 | Ruthie Rayford | Non-emergency Medical Transport (VAN) | 7244 Grande Bay Cove, Memphis, TN 38125 | 2017-08-25 |
| 1952769119 | Crestwyn Health Group, LLC | Psychiatric Hospital | 9485 Crestwyn Hills Cove, Memphis, TN 38125 | 2016-02-03 |
| 1033590500 | Katherine Brown | Optometrist | 7706 Winchester Road, Suite 105, Memphis, TN 38125 | 2015-06-10 |
| 1073856514 | Quaneshia R Farris | Nurse Practitioner | 7685 Winchester Rd Ste 100, Memphis, TN 38125 | 2013-04-03 |
| 1225379811 | Americare At Southbreeze Assisted Living, LLC | Assisted Living Facility | 3168 Hacks Road Cross, Memphis, TN 38125 | 2013-03-07 |
| 1780934281 | Freds Stores of Tennessee Inc | Pharmacy | 7143 Winchester Rd, Memphis, TN 38125 | 2012-09-12 |
| 1174893598 | Andi Marie Anderson | Nurse Anesthetist, Certified Registered | 3340 Players Club Parkway, Suite 350, Memphis, TN 38125 | 2012-01-02 |
| 1285938266 | Melita Robbins | Behavioral Analyst | 8922 E. Trophy Way, Ste 202, Memphis, TN 38125 | 2011-01-05 |
| Find all providers in zip 38125 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922634575 | Dedicated Physicians Group of Tennessee, Pllc | Non-Pharmacy Dispensing Site | 2252 Lamar Ave, Memphis, TN 38114-6608 | 2020-03-16 |
| 1144568718 | Mid-south Foot and Ankle Specialists, Pllc | Non-Pharmacy Dispensing Site | 1653 Poplar Ave, Memphis, TN 38104 | 2013-01-16 |
| 1538242862 | New Image Family Dentistry M | Non-Pharmacy Dispensing Site | 2713 Mount Moriah Rd Ste 101, Memphis, TN 38115-1620 | 2006-10-23 |
| 1245866896 | Dedicated Physicians Group of Tennessee, Pllc | Non-Pharmacy Dispensing Site | 5131 Quince Rd, Memphis, TN 38117-6846 | 2020-03-16 |
| 1891328993 | Dedicated Physicians Group of Tennessee, Pllc | Non-Pharmacy Dispensing Site | 1056 E Raines Rd, Memphis, TN 38116-6337 | 2020-02-17 |
| 1407338320 | Mid-south Foot and Ankle Specialists, Pllc | Non-Pharmacy Dispensing Site | 5677 S Rex Rd, Memphis, TN 38119-3821 | 2018-09-06 |
| 1861935132 | Gastroenterology Center of The Midsouth PC | Non-Pharmacy Dispensing Site | 1325 Eastmoreland Ave, Suite 435, Memphis, TN 38104-3519 | 2016-11-18 |
| 1447792536 | Methodist Healthcare Community Care Association | Non-Pharmacy Dispensing Site | 1803 Union Ave, Suite 2, Memphis, TN 38104-3942 | 2016-11-07 |
| 1518351246 | Urgent Medical Clinic Inc | Non-Pharmacy Dispensing Site | 6515 Poplar Ave, Suite 106, Memphis, TN 38119-4878 | 2015-03-19 |
| 1235458159 | Family Cancer Center Pllc | Non-Pharmacy Dispensing Site | 6005 Park Ave, Suite 1000-b, Memphis, TN 38119-5202 | 2010-05-18 |
| Find all providers in MEMPHIS | ||||
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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.