PATRICIO A. ILABACA, MD, PC (NPI# 1386744514) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386744514 |
| Entity Type | Organization |
| Organization Name | PATRICIO A. ILABACA, MD, PC |
| Other Organization Name | CARDIOVASCULAR & THORACIC SURGERY |
| Practice Address |
6027 Walnut Grove Rd Suite 114 Memphis TN 38120-2145 |
| Practice Telephone | 9016836161 |
| Practice Fax Number | 9016837998 |
| Mailing Telephone | 9016836161 |
| Mailing Fax Number | 9016837998 |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2010-10-18 |
| Authorized Official Name | DR. PATRICIO A. ILABACA (PRESIDENT) |
| Authorized Official Telephone | 9016836161 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
9582 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 09015252 | 05 | |
| TN | 3171424 | 05 |
| Other Name | Type Code |
|---|---|
| cardiovascular & thoracic surgery | Other Name - Individual/Organization |
| Street Address |
6027 WALNUT GROVE RD SUITE 114 |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38120-2145 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417942988 | Monica Armstead Pasley | Obstetrics & Gynecology | 6027 Walnut Grove Rd, Suite 216, Memphis, TN 38120-2145 | 2005-09-12 |
| 1346896123 | Anna Lee Marcy | Nurse Practitioner | 6027 Walnut Grove Rd, Memphis, TN 38120-2145 | 2019-08-16 |
| 1962940866 | Stephanie Lyon | Nurse Practitioner | 6027 Walnut Grove Rd, Memphis, TN 38120-2145 | 2017-02-10 |
| 1497206908 | Devinn N Wolfe | Nurse Practitioner | 6027 Walnut Grove Rd, Memphis, TN 38120-2145 | 2016-10-19 |
| 1659829521 | Jennifer King | Nurse Practitioner | 6027 Walnut Grove Rd, Memphis, TN 38120-2145 | 2016-09-20 |
| 1598180812 | Helen Renee Masters | Nurse Practitioner | 6027 Walnut Grove Rd, Suite 206, Memphis, TN 38120-2145 | 2014-02-24 |
| 1225374358 | Ann Christopher Trotter | Nurse Practitioner | 6027 Walnut Grove Rd, Suite 402, Memphis, TN 38120-2145 | 2012-12-18 |
| 1871866830 | Clesheree Stepter | Nurse Practitioner | 6027 Walnut Grove Rd, Suite 206, Memphis, TN 38120-2145 | 2012-02-21 |
| 1508156712 | Tiffany Michelle Herbert | Specialist/Technologist, Other | 6027 Walnut Grove Rd, Memphis, TN 38120-2145 | 2011-04-10 |
| 1114172376 | Hiren Sampatraj Pokharna | Internal Medicine | 6027 Walnut Grove Rd, Memphis, TN 38120-2145 | 2008-12-01 |
| Find all providers in the same location | ||||
| 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 | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| 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 Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215548375 | Center for Vein Restoration Tn Pllc | Surgery | 6005 Park Ave Ste 225b, Memphis, TN 38119-5207 | 2020-08-12 |
| 1679969729 | Jeffrey Thomas Johnston | Surgery | 910 Madison Ave Fl 2, Memphis, TN 38103-3403 | 2015-04-15 |
| 1528289808 | Shaun Michael Stickley | Surgery | 1325 Eastmoreland Ave Ste 310, Memphis, TN 38104-7544 | 2007-05-02 |
| 1992813158 | Larry Dale Burke | Surgery | 6025 Walnut Grove Rd Ste 311, Memphis, TN 38120-2123 | 2006-08-28 |
| 1073538823 | Jonathan J Ellichman | Surgery | 6401 Poplar Ave Ste 410, Memphis, TN 38119-4808 | 2006-07-13 |
| 1306112487 | Jorge Luis Weber Guzman | Surgery | 6025 Walnut Grove Rd Ste 301, Memphis, TN 38120-2123 | 2012-03-22 |
| 1881901163 | James Eric Gardner, Md, PC | Surgery | 1750 Madison Ave, Suite 300, Memphis, TN 38104-6492 | 2010-09-08 |
| 1952555666 | Prateek Kumar Gupta | Surgery | 1325 Eastmoreland Ave, Suite 310, Memphis, TN 38104-3519 | 2008-11-07 |
| 1770789349 | Larry Burke, Md, PC | Surgery | 6025 Walnut Grove Rd, #311, Memphis, TN 38120-2131 | 2007-06-21 |
| 1801009089 | James Eric Gardner | Surgery | 1750 Madison Ave, Suite 300, Memphis, TN 38104-6492 | 2007-05-07 |
| Find all providers in MEMPHIS | ||||
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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.