NORTH STAR INSTITUTE FOR AUTISM AND RELATED CONDITIONS (NPI# 1134749526) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134749526 |
| Entity Type | Organization |
| Organization Name | NORTH STAR INSTITUTE FOR AUTISM AND RELATED CONDITIONS |
| Practice Address |
1138 N Germantown Pkwy Ste 101-120 Cordova TN 38016-5872 |
| Practice Telephone | 9014683366 |
| Mailing Telephone | 9014683366 |
| Enumeration Date | 2020-04-25 |
| Last Update Date | 2020-04-25 |
| Authorized Official Name | DR. TANJALA GIPSON (FOUNDER/CEO) |
| Authorized Official Telephone | 9014683366 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0008X |
Pediatrics Specialization: Neurodevelopmental Disabilities |
Allopathic & Osteopathic Physicians |
| Street Address |
1138 N GERMANTOWN PKWY STE 101-120 |
| City | CORDOVA |
| State | TN |
| Zip Code | 38016-5872 |
| 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 | 2080P0008X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Neurodevelopmental Disabilities |
| A pediatrician who treats children having developmental delays or learning disorders including those associated with visual and hearing impairment, mental retardation, cerebral palsy, spina bifida, autism and other chronic neurologic conditions. This specialist provides medical consultation and education and assumes leadership in the interdisciplinary management of children with neurodevelopmental disorders. They may also focus on the early identification and diagnosis of neurodevelopmental disabilities in infants and young children as well as on changes that occur as the child with developmental disabilities grows. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed] 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821294331 | Alice Lawrence | Pediatrics | 2200 Childrens Way, 11101 Dot, Nashville, TN 37232-9003 | 2007-06-22 |
| 1528113602 | Tanjala Trinette Gipson | Pediatrics | 51 N Dunlap St Ste 400, Memphis, TN 38105-4625 | 2007-01-25 |
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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.