DR. GREGORY ALAN TETRAULT (NPI# 1366458127) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366458127 |
| Entity Type | Individual |
| Full Name | DR. GREGORY ALAN TETRAULT |
| Credential | M. D. |
| Practice Address |
1030 Jefferson Ave Medical Center 614/113 Memphis TN 38104-2127 |
| Mailing Address |
1603 Pecan Ridge Dr Collierville TN 38017-9096 |
| Practice Telephone | 9015238990 |
| Practice Fax Number | 9015777284 |
| Mailing Telephone | 9018613716 |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0105X |
Pathology Specialization: Clinical Pathology/Laboratory Medicine |
37956 | TN | Allopathic & Osteopathic Physicians |
| Street Address |
1030 JEFFERSON AVE MEDICAL CENTER 614/113 |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38104-2127 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982697025 | Katherine Denton Sanford | Optometrist | 1030 Jefferson Ave, Mail Code 112d, Memphis, TN 38104-2127 | 2005-08-24 |
| 1528667938 | Mckenzie Bahl | Recreation Therapist | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2020-10-19 |
| 1427656834 | Phillip David Resuggan | Music Therapist | 1030 Jefferson Ave, Memphis, TN 38104-2193 | 2020-10-16 |
| 1962009159 | Rachel Diann Roberts | Nurse Anesthetist, Certified Registered | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2020-10-01 |
| 1225643018 | Melanie Warren | Nurse Practitioner | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2020-09-09 |
| 1942828892 | Brady Cole | Pharmacist | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2020-07-08 |
| 1457978595 | Mariko Thel | Pharmacist | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2020-07-05 |
| 1215554910 | Weston Paul Keen | Pharmacy | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2020-06-29 |
| 1225655236 | Rebecca Fong | Pharmacist | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2020-06-26 |
| 1225653660 | Brandy Hollums | Pharmacist | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2020-06-11 |
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| 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 | 207ZP0105X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Clinical Pathology/Laboratory Medicine |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| 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 Pathology, 2007. http://www.abpath.org/. American Osteopathic Board of Pathology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pathology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700299765 | Marshall Goren | Pathology | 5726 Quince Rd Apt 13, Memphis, TN 38119-7010 | 2014-06-07 |
| 1013178854 | Armita Bahrami | Pathology | 262 Danny Thomas Pl, Memphis, TN 38105-3678 | 2008-06-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437704558 | Fairpricelabs | Pathology | 309 2nd Ave Nw, Winchester, TN 37398-1659 | 2019-08-06 |
| 1710266952 | Thomas C Watkins | Pathology | 1601 Ailor Ave, Knoxville, TN 37921-6702 | 2011-08-05 |
| 1457689069 | Garrett Scott Booth | Pathology | 4650h The Vanderbilt Clinic, 1301 Medical Center Drive, Nashville, TN 37232-0001 | 2009-11-20 |
| 1205896420 | Randall James Briley | Pathology | 400 N. Highland Avenue, Middle Tn Medical Center, Murfreesboro, TN 37133 | 2006-03-23 |
| 1245523745 | Jessica Suzanne Thomas | Pathology | 1161 21st Ave S, Vumc Department of Pathology, Nashville, TN 37232-2561 | 2011-05-17 |
| 1033435706 | Alex Ryder | Pathology | 7945 Wolf River Blvd, Germantown, TN 38138-1762 | 2010-04-20 |
| 1073841573 | Mid South Community Pathology | Pathology | 1805 N Jackson St, Suite 7, Tullahoma, TN 37388-2290 | 2009-11-23 |
| 1972707263 | Martin Hospital Corporation | Pathology | 161 Mount Pelia Rd, Martin, TN 38237-3811 | 2007-06-12 |
| 1669691838 | Mark S. Stonecypher | Pathology | 250 E Broadway Ave, Mpln, Maryville, TN 37804-5782 | 2007-04-25 |
| 1568484582 | Pathologists Laboratory Inc | Pathology | 4733 Andrew Jackson Pkwy, Ste 2c, Hermitage, TN 37076-1365 | 2006-07-25 |
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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.