PATRICK JOSEPH GAVIGAN (NPI# 1538503412) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538503412 |
| Entity Type | Individual |
| Full Name | PATRICK JOSEPH GAVIGAN |
| Credential | M.D. |
| Practice Address |
262 Danny Thomas Pl Ms 277 Memphis TN 38105 |
| Mailing Address |
262 Danny Thomas Pl Ms 277 Memphis TN 38105-3678 |
| Practice Telephone | 9015956395 |
| Mailing Telephone | 9015956395 |
| Enumeration Date | 2013-04-23 |
| Last Update Date | 2018-06-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | 54450 | TN | Allopathic & Osteopathic Physicians |
| Y | 2080P0208X |
Pediatrics Specialization: Pediatric Infectious Diseases |
54450 | TN | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
262 DANNY THOMAS PL MS 277 |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861495889 | Melissa M Hudson | Pediatrics | 262 Danny Thomas Pl, Memphis, TN 38105-3678 | 2005-05-23 |
| 1023618907 | James Michael Burgess | Registered Nurse | 262 Danny Thomas Pl, Memphis, TN 38105-3678 | 2020-10-29 |
| 1669098273 | Cassandra Gerhart | Nurse Anesthetist, Certified Registered | 262 Danny Thomas Pl, Memphis, TN 38105-3678 | 2020-06-19 |
| 1275152589 | Katherine Farabee Bailey | Registered Nurse | 262 Danny Thomas Pl, Memphis, TN 38105-3678 | 2020-04-16 |
| 1144851858 | Chs Tennessee Medical P C | Clinic/Center | 262 Danny Thomas Pl, Memphis, TN 38105-3678 | 2020-01-31 |
| 1285274639 | Alise Murray | Genetic Counselor, MS | 262 Danny Thomas Pl, Memphis, TN 38105-3678 | 2020-01-14 |
| 1053951566 | Mary Margaret Benson | Nurse Practitioner | 262 Danny Thomas Pl, Memphis, TN 38105-3678 | 2020-01-13 |
| 1164062071 | Erma Louise Davis | Nurse Practitioner | 262 Danny Thomas Pl, Memphis, TN 38105-3678 | 2020-01-08 |
| 1821637216 | Heather Gaye Havens | Nurse Practitioner | 262 Danny Thomas Pl, Memphis, TN 38105-3678 | 2020-01-02 |
| 1811534837 | Cody Elizabeth Mcmillan | Nurse Practitioner | 262 Danny Thomas Pl, Memphis, TN 38105-3678 | 2019-12-09 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447887435 | Leeanne Chittom Mcdonald | Dietitian, Registered | Ulps Surgery, 2nd Floor, 50 N. Dunlap, Memphis, TN 38105 | 2020-03-27 |
| 1619508942 | Victoria Mackay | Physician Assistant | 595 Danny Thomas Place, Memphis, TN 38105 | 2020-01-27 |
| 1720436710 | Angela Marie Pratt | Nurse Practitioner | 262 Danny Thomas Blvd, Memphis, TN 38105 | 2016-05-31 |
| 1326434465 | Amanda Green | Pediatrics | 262 N Danny Thomas Blvd # Ms 320, Memphis, TN 38105 | 2015-04-15 |
| 1467864173 | Nicole Mary Alberts | Psychologist | 262 Danny Thomas Place, Mail Stop 740, Department of Psychology, St Jude Children's Research H, Memphis, TN 38105 | 2014-05-29 |
| 1689004160 | Virginia Carney | Dietitian, Registered | 262 Danny Thomas Place - Mail Stop 732, Memphis, TN 38105 | 2013-11-19 |
| 1447506365 | Nickhill Hitesh Bhakta | Pediatrics | 262 Danny Thomas Way, Ms 721, Memphis, TN 38105 | 2012-07-29 |
| 1457622235 | Healthy Indigent Populations Inc. | Exclusive Provider Organization | 1066 Delmar, Memphis, TN 38105 | 2012-01-25 |
| 1285953265 | Nicholas Steve Phillips | Student in an Organized Health Care Education/Training Program | 262 Danny Thomas Place, Mail Stop 735, Memphis, TN 38105 | 2010-05-31 |
| 1205151776 | Kyle Joseph Morgan | Anesthesiology | 262 Danny Thomas Pl Dept Of, Memphis, TN 38105 | 2010-03-28 |
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| Taxonomy Code | 2080P0208X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Infectious Diseases |
| A pediatrician trained to care for children in the diagnosis, treatment and prevention of infectious diseases. This specialist can apply specific knowledge to affect a better outcome for pediatric infections with complicated courses, underlying diseases that predispose to unusual or severe infections, unclear diagnoses, uncommon diseases and complex or investigational treatments. |
| 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) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053666453 | Akinobu Kamei | Pediatrics | 262 Danny Thomas Pl # Ms 320, Memphis, TN 38105-3678 | 2012-07-21 |
| 1770036915 | Sarah Habbal | Pediatrics | 262 Danny Thomas Pl, Mail Stop 320, Memphis, TN 38105-3678 | 2016-07-24 |
| 1093129827 | Diego Raul Hijano | Pediatrics | 262 Danny Thomas Pl, Memphis, TN 38105 | 2014-06-19 |
| 1104173384 | Joshua Wolf | Pediatrics | 262 Danny Thomas Pl, Mailstop 320, Memphis, TN 38105-3678 | 2012-08-07 |
| 1467774844 | Maria Alejandra Carrillo-marquez | Pediatrics | 51 N Dunlap St Ste 400, Memphis, TN 38105-4625 | 2010-02-25 |
| 1184835837 | Bindiya Bagga | Pediatrics | 51 N Dunlap St, Memphis, TN 38105-4625 | 2007-05-24 |
| 1528283819 | Gabriela Maria Maron | Pediatrics | 262 Danny Thomas Pl, Memphis, TN 38105-3678 | 2007-04-13 |
| 1770707234 | Isao Miyairi | Pediatrics | 920 Madison Ave, Suite C50, Memphis, TN 38163-0001 | 2007-04-13 |
| 1972550432 | Patricia Joan Chesney | Pediatrics | 1910 Nonconnah Blvd, Suite 120, Memphis, TN 38132-2113 | 2006-05-30 |
| 1083671168 | John P Devincenzo | Pediatrics | 1910 Nonconnah Blvd, Suite 120, Memphis, TN 38132-2113 | 2006-05-01 |
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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.