DR. RICHARD G WANDERMAN (NPI# 1184724312) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184724312 |
| Entity Type | Individual |
| Full Name | DR. RICHARD G WANDERMAN |
| Credential | MD |
| Practice Address |
6077 Apple Tree Dr #5 Memphis TN 38115-8622 |
| Practice Telephone | 9013750551 |
| Practice Fax Number | 9017958661 |
| Mailing Telephone | 9013750551 |
| Mailing Fax Number | 9017958661 |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2014-10-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207KA0200X |
Allergy & Immunology Specialization: Allergy |
22468 | TN | Allopathic & Osteopathic Physicians |
| Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
22468 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 3194814 | 05 |
| Street Address |
6077 APPLE TREE DR #5 |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38115-8622 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164867362 | Malc, LLC | Home Health | 6077 Apple Tree Dr, Suite # 4, Memphis, TN 38115-8622 | 2013-05-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891315370 | Janell Lennice C Jackson | Pharmacist | 3670 Riverdale Road, Memphis, TN 38115 | 2020-04-24 |
| 1982246393 | A.y Nunley | Technician | 5614 Crepe Myrtle Drive, Memphis, TN 38115 | 2019-10-17 |
| 1114580776 | Dee's Around The Clock | Home Health Aide | 6099 Apple Tree Suite35, Optional, Memphis, TN 38115 | 2019-04-19 |
| 1679047476 | Demetria S Summers | Home Health | 6099 Appletree, Suite35, Memphis, TN 38115 | 2019-01-15 |
| 1134698590 | Patriot Healthcare of Tennessee, LLC | Family Medicine | 3175 Lenox Park Boulevard, Suite 100, Memphis, TN 38115 | 2018-11-15 |
| 1891293106 | Decrese A Beverly | Counselor | 5405 Fox Plaza Dr # 108g, Memphis, TN 38115 | 2018-02-01 |
| 1720597289 | Frank A Taylor Jr. | Nutritionist | 6061 Hickory Ridge Mall Ste. 452, Memphis, TN 38115 | 2017-09-27 |
| 1255717260 | Mary L Avery | Social Worker | 5563 Knight Arnold Rd., Memphis, TN 38115 | 2015-08-03 |
| 1104207166 | Good Shepherd Medication Management | Pharmacy | 6052 Hickory Ridge Mall Ste 148, Memphis, TN 38115 | 2015-06-16 |
| 1265811665 | Good Shepherd Health | Pharmacy | 6052 Hickory Ridge Mall, Suite 148, Memphis, TN 38115 | 2015-05-19 |
| Find all providers in zip 38115 | ||||
| Taxonomy Code | 2080A0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Adolescent Medicine |
| 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. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033516109 | Comprehensive Pediatrics | Pediatrics | 4250 Faronia Road, Suite 3, Memphis, TN 38116 | 2014-12-04 |
| 1063597979 | James Langston Cowan IIi | Pediatrics | 6073 Mt. Moriah Ext., Suite 2, Memphis, TN 38115 | 2006-10-26 |
| 1164511085 | Svetlana Yanishevski | Pediatrics | 5050 Sanderlin, Memphis, TN 38117 | 2006-10-11 |
| 1790735124 | Tamara P Folz | Pediatrics | 1102 Brookfield Road, 2nd Floor, Memphis, TN 38119 | 2006-05-10 |
| 1346649894 | Kids Care Medical Center | Pediatrics | 6073 Mt Moriah Rd Ext, Suite 2, Memphis, TN 38115-2666 | 2014-08-21 |
| 1548514771 | Contemporary Pediatrics, Pa | Pediatrics | 4250 Faronia Rd, Memphis, TN 38116-6527 | 2012-11-09 |
| 1508027459 | Preeti Palakurthi | Pediatrics | 2860 Covington Pike, Memphis, TN 38128-8090 | 2008-06-23 |
| 1487797536 | Memphis & Shelby County Pediatric Group | Pediatrics | 6479 Winchester Rd, Suite 118, Memphis, TN 38115-4240 | 2007-02-15 |
| 1376622811 | James F. Stanford | Pediatrics | 5575 Poplar Ave, Ste 112, Memphis, TN 38119-3856 | 2006-11-03 |
| 1699857680 | Charles Christopher Hanson | Pediatrics | 5050 Sanderlin, Memphis, TN 38117 | 2006-10-19 |
| 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.