MEMPHIS SPINE AND SPORT, PLLC (NPI# 1104374412) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104374412 |
| Entity Type | Organization |
| Organization Name | MEMPHIS SPINE AND SPORT, PLLC |
| Practice Address |
1740 N Germantown Pkwy Suite 6 Cordova TN 38016-3307 |
| Practice Telephone | 9017524300 |
| Practice Fax Number | 9012447072 |
| Mailing Telephone | 9017524300 |
| Mailing Fax Number | 9012447072 |
| Enumeration Date | 2016-09-15 |
| Last Update Date | 2018-03-30 |
| Authorized Official Name | DR. CHARLES MAZAS HOGAN (OWNER) |
| Authorized Official Telephone | 9017524300 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 2912 | TN | Chiropractic Providers |
| Street Address |
1740 N GERMANTOWN PKWY SUITE 6 |
| City | CORDOVA |
| State | TN |
| Zip Code | 38016-3307 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457449928 | Jeffrey Alan Kowachik | Chiropractor | 1740 N Germantown Pkwy, Ste. 5, Cordova, TN 38016-3307 | 2006-10-10 |
| 1003274812 | Charles Hogan | Chiropractor | 1740 N Germantown Pkwy, Suite #6, Cordova, TN 38016-3307 | 2016-02-08 |
| 1932476694 | Memphis Chiropractic Neurology, Inc | Chiropractor | 1740 N Germantown Pkwy, Suite 6, Cordova, TN 38016-3307 | 2011-11-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548886872 | Megan Scott Bolton | Physical Therapist | 8110 Cordova Road Suite 107, Cordova, TN 38016 | 2020-06-23 |
| 1477195451 | Jacqueline Reeves Thomas | Counselor | Memphis Veterans Affairs Medical Center (vamc), 1030 Jefferson Ave, Memphis, TN 38016 | 2019-10-11 |
| 1376195842 | Robert Cody Heismann | Physical Therapist | 8110 Cordova Rd, Ste 107, Cordova, TN 38016 | 2019-07-15 |
| 1881189702 | Carolyn Bean | Home Health Aide | 1786 Beaver Trail Dr, Cordova, TN 38016 | 2018-06-22 |
| 1255776886 | Suzanne Elaine Baker | Family Medicine | 2257 North Germantown Parkway, Memphis, TN 38016 | 2013-05-09 |
| 1487806683 | Janet Lee Ferrell | Counselor | 1340 Siskin Drive, Cordova, TN 38016 | 2008-10-21 |
| 1114186624 | Rebecca L Bills | Optometrist | 1795 N Germantown Pkwy, Cordova, TN 38016 | 2008-06-09 |
| 1679784128 | Linda Kay Yates | Emergency Medicine | 1401 Dexter Lane, Cordova, TN 38016 | 2007-05-25 |
| 1417168386 | Healthquest | Psychiatry & Neurology | 58 Timber Creek, Cordova, TN 38016 | 2007-05-24 |
| 1114079795 | Barbara T Henking | Psychologist | 8134 Country Village, #102, Cordova, TN 38016 | 2007-01-17 |
| Find all providers in zip 38016 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154951408 | Richard Donald Bingham | Chiropractor | 622 1st Street, 201, Cordova, AK 99574 | 2020-01-24 |
| 1477197598 | Chiro-r-us | Chiropractor | 8014 Club Center Dr Ste 5, Cordova, TN 38016-8666 | 2019-10-31 |
| 1609418086 | Memphis Regenerative Healthcare LLC | Chiropractor | 7981 Dexter Rd Ste 101, Cordova, TN 38016-8798 | 2019-10-17 |
| 1730655663 | Memphis Spine and Sport | Chiropractor | 1740 N Germantown Pkwy Ste 6, Cordova, TN 38016-3308 | 2018-10-18 |
| 1568811453 | Christopher Gross | Chiropractor | 8181 Emerald Creek Ln, # 201, Cordova, TN 38016-2071 | 2016-06-10 |
| 1821254210 | Jared M Wootton | Chiropractor | 680 N Germantown Pkwy, Suite 44, Cordova, TN 38018-6282 | 2008-08-05 |
| 1336268812 | Dale Ford Smith | Chiropractor | 7981 Dexter Rd, Suite 101, Cordova, TN 38016-8798 | 2007-03-28 |
| 1265564629 | Terry L Bartley | Chiropractor | 105 Council Ave W, Cordova, AK 99574-0579 | 2007-03-12 |
| 1114064037 | Bobby L. Myers II | Chiropractor | 830 N Germantown Pkwy, Suite 109, Cordova, TN 38018-6265 | 2007-01-31 |
| 1568530038 | Audra Arstikaitis-nagel | Chiropractor | 256 Germantown Bend Cv., Suite 103, Cordova, TN 38018 | 2006-12-01 |
| Find all providers in CORDOVA | ||||
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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.