SOUTHEASTERN EMERGENCY PHYSICIANS OF MEMPHIS LLC (NPI# 1437105277) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437105277 |
| Entity Type | Organization |
| Organization Name | SOUTHEASTERN EMERGENCY PHYSICIANS OF MEMPHIS LLC |
| Other Organization Name | S E EMERGENCY PHYS MEMPHIS |
| Practice Address |
1 Memorial Dr Alton IL 62002-6722 |
| Mailing Address |
Po Box 633819 Cincinnati OH 45263-3819 |
| Practice Telephone | 6184637474 |
| Mailing Telephone | 8882031274 |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2020-09-29 |
| Authorized Official Name | DR. MICHAEL D CORVINI (PRESIDENT) |
| Authorized Official Telephone | 8652935205 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207PP0204X |
Emergency Medicine Specialization: Pediatric Emergency Medicine |
TN | Allopathic & Osteopathic Physicians | |
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207P00000X | Emergency Medicine | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 3728394 | 05 | |
| IN | 200924580A | 05 | |
| MO | 507218402 | 05 | |
| AR | 158441002 | 05 | |
| AL | 529932817 | 05 | |
| KS | 200533140A | 05 | |
| KY | 65909962 | 05 | |
| KY | 65919342 | 05 |
| Other Name | Type Code |
|---|---|
| S E Emergency Phys Memphis | Former Legal Business Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 910 Blackford St, Chattanooga, TN 374031405 | 8004243672 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114309168 | Southeastern Emergency Physicians of Memphis LLC | Physician Assistant | 5000 Hopyard Rd, Suite 100, Pleasanton, CA 94588-3348 | 2015-06-26 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Southeastern Emergency Physicians of Memphis LLC | 265 Brookview Centre Way Ste 400, Knoxville, Tennessee 37919 |
| Street Address |
1 MEMORIAL DR |
| City | ALTON |
| State | IL |
| Zip Code | 62002-6722 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174504682 | Mary Colette Schmidt | Internal Medicine | 1 Memorial Dr, Alton, IL 62002-6722 | 2005-11-10 |
| 1093323131 | Alton Memorial Hospital | Clinical Medical Laboratory | 1 Memorial Dr, Alton, IL 62002-6722 | 2020-07-15 |
| 1295358810 | Andrew James Standefer | Registered Nurse | 1 Memorial Dr, Alton, IL 62002-6722 | 2020-05-19 |
| 1356988273 | Clair Laurent Visconti | Physician Assistant | 1 Memorial Dr, Alton, IL 62002-6722 | 2019-12-10 |
| 1932682101 | Hannah Josephine Mallets | Occupational Therapist | 1 Memorial Dr, Alton, IL 62002-6722 | 2018-09-12 |
| 1154826501 | Aaron D Wede | Nurse Anesthetist, Certified Registered | 1 Memorial Dr, Alton, IL 62002 | 2018-03-28 |
| 1841710712 | Jodi Keiko Pecka Yanagida | Internal Medicine | 1 Memorial Dr, Alton, IL 62002-6722 | 2017-06-22 |
| 1265960058 | Chandni Sinha | Internal Medicine | 1 Memorial Dr, Alton, IL 62002-6722 | 2017-05-24 |
| 1033657929 | Meredith Anne Parker | Social Worker | 1 Memorial Dr, 2nd Floor, Olin Wing, Alton, IL 62002-6722 | 2017-02-10 |
| 1942758081 | Brennan Malham | Physician Assistant | 1 Memorial Dr, Alton, IL 62002-6722 | 2016-09-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285272807 | Jersey Community Hospital | Obstetrics & Gynecology | #2 Memorial Drive, Suite 203, Alton, IL 62002 | 2019-12-13 |
| 1912540659 | Kelsi N Harre | Community Health Worker | 2603 N. Rogers Ave., Alton, IL 62002 | 2019-10-25 |
| 1841848322 | Destiny L Miller | Technician | 3429 Meridocia St, Alton, IL 62002 | 2019-08-28 |
| 1942854633 | Jessica Leigh Jump | Speech-Language Pathologist | 453 Bluff Street, Alton, IL 62002 | 2019-07-30 |
| 1194380741 | Vasiliki Kytridou | Dentist | 2800 College Avenue Southern Il University School of De, Building 285, Alton, IL 62002 | 2019-05-08 |
| 1982125910 | Amy Nicole Spalding | Social Worker | 1123 Harrison St, Alton, IL 62002 | 2017-06-29 |
| 1962856310 | Patricia Gregory | Social Worker | 5090 Humbert Rd, Alton, IL 62002 | 2016-04-21 |
| 1447612510 | Alanna Lynn Mcnelly | Chiropractor | 219 Piasa St, Suite 200, Alton, IL 62002 | 2016-03-28 |
| 1174983050 | Roberta's Lovely Ladies Boutique | Mastectomy Fitter | 603 W. Delmar, Alton, IL 62002 | 2016-03-04 |
| 1184081556 | Darcy Graham | Nurse Practitioner | 4 Memorial Dr # 210, Alton, IL 62002 | 2016-01-15 |
| Find all providers in zip 62002 | ||||
| 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 |
|---|---|---|---|---|
| 1245693977 | Medexpress Urgent Care Illinois, P.C. | Emergency Medicine | 1704 Homer M Adams Parkway, Alton, IL 62002-5603 | 2016-03-31 |
| 1184005910 | James Brody Reid | Emergency Medicine | 1 Memorial Dr, Alton, IL 62002-6722 | 2015-06-17 |
| 1942687603 | Teya Casner | Emergency Medicine | 1 Memorial Dr, Alton, IL 62002 | 2015-05-01 |
| 1215355110 | Healogics Specialty Physicians of Illinois, LLC | Emergency Medicine | 1 Memorial Dr, Alton, IL 62002-6722 | 2014-03-29 |
| 1881701050 | Ching Fa Hsu | Emergency Medicine | 1 Saint Anthonys Way, Alton, IL 62002-4568 | 2006-08-24 |
| 1700803335 | David Riesenberger | Emergency Medicine | 1 Memorial Dr, Alton, IL 62002-6722 | 2006-07-17 |
| 1346267978 | Craig Rosenberg | Emergency Medicine | 1 Memorial Dr, Alton, IL 62002-6722 | 2006-07-17 |
| 1124045752 | David Wayne Burnside | Emergency Medicine | 1 Memorial Dr, Alton, IL 62002-6722 | 2006-07-17 |
| 1023035573 | Matthew E Duban | Emergency Medicine | 1 Memorial Dr, Alton, IL 62002-6722 | 2006-07-17 |
| 1326065962 | Alan Johnson | Emergency Medicine | 1 Memorial Dr, Alton, IL 62002-6722 | 2006-07-17 |
| Find all providers in ALTON | ||||
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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.