SHANE W. COUGHLIN (NPI# 1336441419) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336441419 |
| Entity Type | Individual |
| Full Name | SHANE W. COUGHLIN |
| Credential | MD |
| Practice Address |
1407 Union Ave Suite 200 Memphis TN 38104-3600 |
| Mailing Address |
1407 Union Ave Suite 640 Memphis TN 38104-3666 |
| Practice Telephone | 9018668813 |
| Practice Fax Number | 9013022120 |
| Mailing Telephone | 9018668360 |
| Mailing Fax Number | 9013022360 |
| Enumeration Date | 2010-11-23 |
| Last Update Date | 2020-07-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | MT213433 | PA | Allopathic & Osteopathic Physicians |
| Street Address |
1407 UNION AVE SUITE 200 |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38104-3600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962460998 | Michael C Mcconnell | Nurse Anesthetist, Certified Registered | 1407 Union Ave, Suite 200, Memphis, TN 38104-3600 | 2006-05-01 |
| 1649779760 | Kristen Davenport Locke | Nurse Practitioner | 1407 Union Ave, Memphis, TN 38104-3627 | 2018-02-04 |
| 1346769866 | Memphis Health & Wellness | Nurse Practitioner | 1407 Union Ave, Suite 107, Memphis, TN 38104 | 2017-09-15 |
| 1306206529 | Victoria Traylor | Counselor | 1407 Union Ave, Suite 100, Memphis, TN 38104-3627 | 2016-03-01 |
| 1841659232 | Omni Community Health | Clinic/Center | 1407 Union Ave, Suite 100, Memphis, TN 38104-3627 | 2016-02-15 |
| 1316320880 | Omni Community Health | Community/Behavioral Health | 1407 Union Ave, Suite 815, Memphis, TN 38104-3679 | 2015-07-02 |
| 1326436452 | Memphis Vamc | Clinic/Center | 1407 Union Ave, 11th Floor, Memphis, TN 38104-3627 | 2014-12-23 |
| 1962839324 | Heather L Gammel | Psychologist | 1407 Union Ave, Memphis, TN 38104-3627 | 2013-10-01 |
| 1235482522 | Allison Thornell West | General Acute Care Hospital | 1407 Union Ave, Memphis, TN 38104-3627 | 2012-10-24 |
| 1700185089 | Sanjaya Kumar Satapathy | Internal Medicine | 1407 Union Ave, Suite 640, Memphis, TN 38104-3627 | 2011-03-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952900367 | Christy White | Recreation Therapist | 1030 Jefferson Ave (rt117), Memphis, TN 38104 | 2020-10-19 |
| 1821615873 | Altiana Carter | Optometrist | 650 New York St, Memphis, Tn 38104, Memphis, TN 38104 | 2020-06-25 |
| 1952898413 | Family To Family Adult Care Service | Chore Provider | 1331 Union Ave Suite 1028, Mempnis, TN 38104 | 2018-04-19 |
| 1326544800 | Kimberly Vestoria Mcclinton | Nurse Practitioner | 2200 Union Ave 1, Memphis, TN 38104 | 2018-04-03 |
| 1649799339 | Benjamin Duhart Jr. | Pharmacist | 1265 Union Avenue- Methodist University Hospital, Ground Floor Pharmacy Administration, Memphis, TN 38104 | 2017-09-13 |
| 1134644982 | Amy Michelle Wise | Nurse Practitioner | 1325 Eastmoreland Ave Ste 500, Memphis, TN 38104 | 2017-08-13 |
| 1316468572 | Jinger Cathey | Social Worker | 1330 Jefferson Ave, Memphis, TN 38104 | 2017-06-28 |
| 1336669183 | Charma May Kavuncu | Social Worker | 1407 Union Ave Ste 1100, Memphis, TN 38104 | 2017-06-22 |
| 1003345398 | Angelica J Dennis | Nurse Practitioner | 1265 Union, Memphis, TN 38104 | 2017-06-08 |
| 1609302546 | Cheryl Beene | Nurse Practitioner | 1211 Union Ave Ste 475, Memphis, TN 38104 | 2017-05-11 |
| Find all providers in zip 38104 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891287090 | Shelby Linwood Gillette Jr. | Emergency Medicine | 170 S Goodlett St Ste A, Memphis, TN 38117-2914 | 2018-06-04 |
| 1710413885 | Michael Sidney Reich | Emergency Medicine | 665 Tennessee St, Memphis, TN 38103-8794 | 2017-05-10 |
| 1871049023 | Keystone Medical Services of West Point Inc | Emergency Medicine | 6075 Poplar Avenue, Suite 401, Memphis, TN 38119-0114 | 2016-08-28 |
| 1740634054 | Thomas Oswald | Emergency Medicine | 251 S Claybrook St Ste A206, Memphis, TN 38104-3539 | 2016-04-22 |
| 1134573777 | Amanda Box | Emergency Medicine | 251 S Claybrook St Ste A-206, Memphis, TN 38104-3539 | 2016-04-20 |
| 1265811590 | Elizabeth Coombs Gamble | Emergency Medicine | 50 N Dunlap St # 20, Memphis, TN 38103 | 2015-05-19 |
| 1154716306 | Kimberly Michelle Brown | Emergency Medicine | 104 Sawyer Cir Apt 494, Memphis, TN 38103 | 2015-04-04 |
| 1316352099 | Daniel Poor | Emergency Medicine | Baptist Memorial Hospital Memphis, 124 N. Humphrey's Blvd, Memphis, TN 38120 | 2014-06-21 |
| 1528472289 | Diego S Espinoza | Emergency Medicine | 4095 American Way Ste 1, Memphis, TN 38118-8339 | 2014-06-19 |
| 1881037554 | Cailin Mckenna Frank | Emergency Medicine | 51 N Dunlap St, Ste 100, Lebonheur Children's Hospital - Er, Memphis, TN 38103 | 2013-04-12 |
| 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.