MID-SOUTH MATERNAL FETAL MEDICINE PC (NPI# 1184662579) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184662579 |
| Entity Type | Organization |
| Organization Name | MID-SOUTH MATERNAL FETAL MEDICINE PC |
| Practice Address |
6266 Poplar Ave Memphis TN 38119-4713 |
| Practice Telephone | 9016822595 |
| Practice Fax Number | 9016822549 |
| Mailing Telephone | 9016822595 |
| Mailing Fax Number | 9016822549 |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2011-12-12 |
| Authorized Official Name | ERIC W GIBSON (CEO) |
| Authorized Official Telephone | 9013738949 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VM0101X |
Obstetrics & Gynecology Specialization: Maternal & Fetal Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 155822002 | 05 | |
| TN | 3720439 | 05 | |
| AR | BCBS AR | 8P412 | 01 |
| MS | 07470206 | 05 |
| Street Address |
6266 POPLAR AVE |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38119-4713 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801360516 | Laura Elizabeth Maurizi | Obstetrics & Gynecology | 6266 Poplar Ave, Memphis, TN 38119-4713 | 2019-01-15 |
| 1902129414 | Teresa Flowers Strickland | Nurse Practitioner | 6266 Poplar Ave, Memphis, TN 38119-4713 | 2010-03-11 |
| 1992999791 | Shelia K Thomas | Registered Nurse | 6266 Poplar Ave, Memphis, TN 38119-4713 | 2007-09-05 |
| 1366596066 | Regina Christy Smith | Nurse Practitioner | 6266 Poplar Ave, Memphis, TN 38119-4713 | 2007-01-22 |
| 1871505438 | Roy Bors-koefoed | Obstetrics & Gynecology | 6266 Poplar Ave, Memphis, TN 38119-4713 | 2006-08-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417469628 | Jojuan Fullwiley | Behavioral Analyst | 6685 Quince Rd Ste 116, Memphis, TN 38119 | 2017-10-27 |
| 1336675297 | Jill Budynas Depriest | Counselor | 5583 Murray Ave Ste 203, Memphis, TN 38119 | 2017-05-11 |
| 1396279220 | Glen Matthew Stamps Jr. | Counselor | 5583 Murray Ave Ste 207, Memphis, TN 38119 | 2017-04-18 |
| 1598117442 | Hazel Aberdeen | Chiropractor | 1911 Memphis Tennessee, Memphis, TN 38119 | 2016-07-04 |
| 1831569060 | E-c-t Non Emergency Medical Transport | Non-emergency Medical Transport (VAN) | 6869 Woodlake Dr, Memphis, TN 38119 | 2015-09-30 |
| 1053781617 | Astrid Roman | Dietitian, Registered | 8020 Hillside Cv, Memphis, MS 38119 | 2015-09-25 |
| 1467857664 | Allan Jacob Katz | Counselor | 5668 Rex Rd, Suite 104, Memphis, TN 38119 | 2014-10-30 |
| 1962836015 | Judy Ann Harrick | Acupuncturist | 5575 Poplar Ave., #702, Memphis, TN 38119 | 2013-08-26 |
| 1366791949 | Jennifer Denyes Bidelman | Audiologist | 5625 Poplar Avenue, Memphis, TN 38119 | 2012-08-29 |
| 1578833620 | Elizabeth Mary Dion-douglass | Pharmacist | 2891 Kirby Parkway, Memphis, TN 38119 | 2012-01-06 |
| Find all providers in zip 38119 | ||||
| Taxonomy Code | 207VM0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Maternal & Fetal Medicine |
| An obstetrician/gynecologist who cares for, or provides consultation on, patients with complications of pregnancy. This specialist has advanced knowledge of the obstetrical, medical and surgical complications of pregnancy and their effect on both the mother and the fetus. The specialist also possesses expertise in the most current diagnostic and treatment modalities used in the care of patients with complicated pregnancies. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801360516 | Laura Elizabeth Maurizi | Obstetrics & Gynecology | 6266 Poplar Ave, Memphis, TN 38119-4713 | 2019-01-15 |
| 1871505438 | Roy Bors-koefoed | Obstetrics & Gynecology | 6266 Poplar Ave, Memphis, TN 38119-4713 | 2006-08-12 |
| 1528005006 | Giancarlo Mari | Obstetrics & Gynecology | 880 Madison Ave, Memphis, TN 38103-3409 | 2006-06-01 |
| 1720045230 | Norman L Meyer | Obstetrics & Gynecology | 880 Madison Ave, Memphis, TN 38103-3409 | 2006-04-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942864467 | Sara C Linarducci | Obstetrics & Gynecology | 903 W Eastland Ave, Nashville, TN 37206-3531 | 2019-04-30 |
| 1144655853 | Rutherford Perinatal Associates Pllc | Obstetrics & Gynecology | 9204 Sheridan Park Ct, Brentwood, TN 37027-1748 | 2013-09-12 |
| 1831530906 | The Perinatal Group | Obstetrics & Gynecology | 2292 Dalton Dr Ste D, Clarksville, TN 37043-8946 | 2013-07-17 |
| 1417152604 | Bill L Duke II Md PC | Obstetrics & Gynecology | 102 Boyd St, Ashland City, TN 37015-1601 | 2007-06-18 |
| 1043332463 | Lynlee Marie Wolfe | Obstetrics & Gynecology | 1925 Alcoa Hwy, Suite 6-south, Knoxville, TN 37920-1507 | 2007-04-05 |
| 1780608331 | Mid-south Perinatal Associates PC | Obstetrics & Gynecology | 620 Skyline Dr., Jackson, TN 38301 | 2006-07-27 |
| 1568409894 | Jorge Gabriel Lodeiro | Obstetrics & Gynecology | 132 W Sevier Ave, Suite 1, Kingsport, TN 37660-3764 | 2006-06-02 |
| 1912968843 | Christian Michael Briery | Obstetrics & Gynecology | 979 E Third Street, Suite C 825, Chattanooga, TN 37403 | 2006-03-30 |
| 1811989098 | Charles David Adair | Obstetrics & Gynecology | 902 Mccallie Ave, Chattanooga, TN 37403-2724 | 2005-08-16 |
| 1023013307 | Periclis Roussis | Obstetrics & Gynecology | 501 19th St., Suite 401, Knoxville, TN 37916-1839 | 2005-06-14 |
| 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.