GOODLIFE MEDICAL CENTER, PLLC (NPI# 1811041668) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811041668 |
| Entity Type | Organization |
| Organization Name | GOODLIFE MEDICAL CENTER, PLLC |
| Practice Address |
756 Ridge Lake Blvd Suite 228 Memphis TN 38120-9420 |
| Mailing Address |
Po Box 172126 Memphis TN 38187-2126 |
| Practice Telephone | 9016851994 |
| Practice Fax Number | 9016851997 |
| Mailing Telephone | 9016851994 |
| Mailing Fax Number | 9016851997 |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2007-09-20 |
| Authorized Official Name | OLUGBENGA ADEBANJO (PRESIDENT) |
| Authorized Official Telephone | 9016851994 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 37598 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 3726671 | 05 |
| Street Address |
756 RIDGE LAKE BLVD SUITE 228 |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38120-9420 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346216678 | Mary C Peterson | Physical Therapist | 756 Ridge Lake Blvd, Ste 205, Memphis, TN 38120-9445 | 2006-02-27 |
| 1497158588 | Richard Brett Prentiss | Physical Therapist | 756 Ridge Lake Blvd, #205, Memphis, TN 38120-9420 | 2014-10-02 |
| 1932431327 | Marcy C Purnell | Nurse Practitioner | 756 Ridge Lake Blvd, Suite 206, Memphis, TN 38120-9420 | 2010-02-09 |
| 1336380096 | Cathy Lee Richardson | Physical Therapist | 756 Ridge Lake Blvd, Suite 205, Memphis, TN 38120-9420 | 2009-03-10 |
| 1730304916 | Titilola Tolulope Adebanjo | Nurse Practitioner | 756 Ridge Lake Blvd, Suite 228, Memphis, TN 38120-9420 | 2007-04-14 |
| 1477695948 | Heather Vinicki Couvillion | Physical Therapist | 756 Ridge Lake Blvd, Suite 205, Memphis, TN 38120-9420 | 2007-02-13 |
| 1851482426 | Quality Health Pllc | Internal Medicine | 756 Ridge Lake Blvd, 228, Memphis, TN 38120-9420 | 2006-09-27 |
| 1558468587 | Robert C Mcewan | Family Medicine | 756 Ridge Lake Blvd, Suite 120, Memphis, TN 38120-9420 | 2006-09-20 |
| 1073626578 | Drewry Family Medicine LLC | Family Medicine | 756 Ridge Lake Blvd, Suite 120, Memphis, TN 38120-9420 | 2006-08-17 |
| 1528074440 | Jennifer H Henderson | Occupational Therapist | 756 Ridge Lake Blvd, Suite 205, Memphis, TN 38120-9420 | 2006-07-31 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093285637 | Cobblestone Midwifery | Midwife | 5617 Ashley Square South, Memphis, TN 38120 | 2018-11-27 |
| 1649768870 | River City Neuropsychology, Pllc | Psychologist | 1661 International Dr., Suite 400, Memphis, TN 38120 | 2018-04-24 |
| 1841676152 | Jody Lavaun Clements | Dentist | 795 Ridge Lake Blvd Ste 101, Memphis, TN 38120 | 2015-08-10 |
| 1578957122 | Christina Lumpkin | Nurse Practitioner | 6305 Humphreys Blvd Ste 101, Memphis, TN 38120 | 2015-03-21 |
| 1316352099 | Daniel Poor | Emergency Medicine | Baptist Memorial Hospital Memphis, 124 N. Humphrey's Blvd, Memphis, TN 38120 | 2014-06-21 |
| 1245643246 | Kysha Saleem | Nurse Practitioner | 6027 Walnut Grove Rd., Suite 312, Memphis, TN 38120 | 2014-06-06 |
| 1376962613 | John Christopher Swearingen | Dentist | 780 Ridge Lake Blvd Ste 101, Memphis, TN 38120 | 2014-04-15 |
| 1275884645 | Rebecca Leigh Goedecke | Nurse Practitioner | 6215 Humphreys Blvd Ste 301, Memphis, TN 38120 | 2012-09-26 |
| 1730475179 | Sarah Elizabeth Hammond | Surgery | Plastic Surgery Group, 80 Humphreys Blvd #100, Memphis, TN 38120 | 2011-06-23 |
| 1922302785 | Daniel L Hester | Nurse Anesthetist, Certified Registered | 1755 Kirby Parkway Suite 330, Memphis, TN 38120 | 2011-01-07 |
| Find all providers in zip 38120 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427546415 | Christopher Nelson | Internal Medicine | 5100 Poplar Ave Ste 512, Memphis, TN 38137-0500 | 2018-04-25 |
| 1356797898 | Shwetapadma Sahu | Internal Medicine | 109 N Main St Apt 811, Memphis, TN 38103-5019 | 2016-05-13 |
| 1780030619 | Lamia Aljundi | Internal Medicine | 956 Court Avenue Suite H316b, Memphis, TN 38163-2148 | 2016-05-10 |
| 1437513439 | Highland Medical Corp | Internal Medicine | 3445 Poplar Ave Ste 13, Memphis, TN 38111-4667 | 2016-04-06 |
| 1760845994 | Anthony Selase Sallar | Internal Medicine | 920 Madison Ave Ste 300a, Memphis, TN 38103-3472 | 2016-04-04 |
| 1306218235 | Amp Medical Management, LLC | Internal Medicine | 1102 Brookfield Rd, Ste 102, Memphis, TN 38119-3826 | 2015-10-30 |
| 1245636596 | Jiten P Kothadia | Internal Medicine | 1265 Union Avenue 4 Shorb Tower, Memphis, TN 38104-4418 | 2014-11-14 |
| 1841614252 | Saurav Acharya | Internal Medicine | 956 Court Avenue G326 Coleman Building, Memphis, TN 38163-2857 | 2014-02-06 |
| 1396182705 | John W Fowler Jr. Md Pllc | Internal Medicine | 184 Colonial Rd, Memphis, TN 38117-3206 | 2013-05-24 |
| 1497198865 | Jeremy Scott Avila | Internal Medicine | 6799 Great Oaks Rd Ste 105, Memphis, TN 38138-2572 | 2013-04-16 |
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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.