MARK C BUGNITZ (NPI# 1023075249) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023075249 |
| Entity Type | Individual |
| Full Name | MARK C BUGNITZ |
| Credential | MD |
| Practice Address |
848 Adams Ave Memphis TN 38103 |
| Mailing Address |
Po Box 5135 Memphis TN 38101-5135 |
| Practice Telephone | 9012877337 |
| Mailing Telephone | 9012877337 |
| Mailing Fax Number | 9012876336 |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2018-05-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
18163 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 3028713 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1910 Nonconnah Blvd, Suite 120, Memphis, TN 381322113 | 9014482300 | 9014486657 |
| Street Address |
848 ADAMS AVE |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437159126 | Barry G Gilmore | Emergency Medicine | 848 Adams Ave, Memphis, TN 38103-2816 | 2005-07-26 |
| 1942816350 | Emily Craven | Registered Nurse | 848 Adams Ave, Memphis, TN 38103-2816 | 2020-09-21 |
| 1851905475 | Sherry Ivy | Clinical Nurse Specialist | 848 Adams Ave, Memphis, TN 38103-2816 | 2020-09-01 |
| 1841800398 | Sarah Phillips | Student in an Organized Health Care Education/Training Program | 848 Adams Ave, Memphis, TN 38103-2816 | 2020-08-07 |
| 1922617240 | Megan Leigh Smith | Nurse Practitioner | 848 Adams Ave, Memphis, TN 38103-2816 | 2020-07-23 |
| 1235753187 | Kelsey Aquadro Mace | Occupational Therapist | 848 Adams Ave, Memphis, TN 38103-2816 | 2020-06-05 |
| 1669094017 | Kelley Little | Physical Therapist | 848 Adams Ave, Memphis, TN 38103-2816 | 2020-05-08 |
| 1669093571 | Amy Claire Petro | Speech-Language Pathologist | 848 Adams Ave, Memphis, TN 38103-2816 | 2020-05-01 |
| 1285255299 | Heather Leann Clabo | Occupational Therapist | 848 Adams Ave, Memphis, TN 38103-2816 | 2020-04-30 |
| 1922629146 | Julie Cleary Dillon | Speech-Language Pathologist | 848 Adams Ave, Memphis, TN 38103-2816 | 2020-04-28 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619505724 | Michelle Lynn Esposito | Dietitian, Registered | 1st Floor Research Center - 50 North Dunlap St, Memphis, TN 38103 | 2020-04-01 |
| 1962030221 | Allison Burge Clayton | Dietitian, Registered | 50 N Dunlap, Nutrition Therapy Dept, 1st Floor Research Tower, Memphis, TN 38103 | 2020-03-31 |
| 1093375420 | Radar Ems, LLC | Social Worker | 50 S. B.b. King Blvd, Suite 350, Memphis, TN 38103 | 2019-06-18 |
| 1528529021 | Denise Andrews Matthews | Nursing Care | 342 Island Dr #105, Memphis, TN 38103 | 2019-03-27 |
| 1881160059 | Christopher Paul Hernandez | Nurse Practitioner | 877 Jeffeon Ave, Memphis, TN 38103 | 2018-10-15 |
| 1194245712 | Cameron Waters Clinard | Optometrist | 127 Isle Creek Dr, Memphis, TN 38103 | 2017-06-24 |
| 1750732582 | Amanda Leigh Eaves | Nurse Practitioner | 364 S Front St Ste 201, Memphis, TN 38103 | 2016-06-22 |
| 1417304569 | John Clark Shell | Family Medicine | 150 Harbor Creek Dr, Memphis, TN 38103 | 2016-05-18 |
| 1750753695 | Tomisha V. Byard | Nurse Practitioner | 718 Habor Bend Road, Memphis, TN 38103 | 2015-10-29 |
| 1053795179 | Melissa Anne Wilkes | Social Worker | 1240 Harbor River Drive, Memphis, TN 38103 | 2015-07-18 |
| Find all providers in zip 38103 | ||||
| Taxonomy Code | 2080P0203X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Critical Care Medicine |
| A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. ACGME Accredited Residency Program Requirements: 2 years of training with 3 years Pediatrics plus 1 year Pediatric Critical Care for certification for a total of 6 years. ABMS Approved Subspecialty Certificate (Pediatrics) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295266906 | Ashlee Christmas | Pediatrics | 920 Madison Avenue Suite 447, Memphis, TN 38163-3818 | 2017-03-23 |
| 1477893121 | Maria Del Pilar Anton Martin | Pediatrics | 51 N Dunlap St Fl 2, Memphis, TN 38105 | 2013-02-17 |
| 1053670273 | Shantaveer Gangu | Pediatrics | 848 Adams Ave, Memphis, TN 38103-2816 | 2012-05-08 |
| 1568729747 | Laurel Jeanette Metzler | Pediatrics | 848 Adams Ave, Memphis, TN 38103-2816 | 2012-04-12 |
| 1689930653 | Sheridan Children's Healthcare Services of Tennessee, PC | Pediatrics | 6225 Humphreys Blvd, Memphis, TN 38120-2373 | 2012-04-04 |
| 1629367909 | Nicholas Paul Morin | Pediatrics | 848 Adams Ave, Memphis, TN 38103 | 2011-04-07 |
| 1639494040 | Asya Agulnik | Pediatrics | 262 Danny Thomas Pl, Memphis, TN 38105-3678 | 2010-03-30 |
| 1538315304 | Samir Hasmukh Shah | Pediatrics | 1910 Nonconnah Blvd, Ste 120, Memphis, TN 38132-2113 | 2008-08-13 |
| 1265651830 | Saad Ghafoor | Pediatrics | 262 Danny Thomas Pl, Memphis, TN 38105-3678 | 2007-04-24 |
| 1871673202 | Nadeem I Shafi | Pediatrics | 848 Adams Ave, Memphis, TN 38103-2816 | 2006-10-17 |
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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.