MEMPHIS PAIN MANAGEMENT GROUP, PC (NPI# 1437449170) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437449170 |
| Entity Type | Organization |
| Organization Name | MEMPHIS PAIN MANAGEMENT GROUP, PC |
| Practice Address |
6100 Primacy Pkwy Suite 112 Memphis TN 38119-0705 |
| Practice Telephone | 9016825335 |
| Mailing Telephone | 9016825335 |
| Enumeration Date | 2011-04-14 |
| Last Update Date | 2013-05-31 |
| Authorized Official Name | RUSSELL D RADICAN (PRESIDENT) |
| Authorized Official Telephone | 9016825335 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 111N00000X | Chiropractor | DC1171 | TN | Chiropractic Providers |
| Y | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
MD430532 | TN | Allopathic & Osteopathic Physicians |
| Street Address |
6100 PRIMACY PKWY SUITE 112 |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38119-0705 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699774539 | Demetria Leonard Davis | Physician Assistant | 6100 Primacy Pkwy, Suite 112, Memphis, TN 38119-0705 | 2005-07-21 |
| 1821389784 | Erin B Meredith | Registered Nurse | 6100 Primacy Pkwy, Suite 105, Memphis, TN 38119-0705 | 2011-04-27 |
| 1134450307 | Robert Larry Smith | Nurse Practitioner | 6100 Primacy Pkwy, Suite 112, Memphis, TN 38119-0705 | 2010-01-27 |
| 1528172368 | Russell D. Radican | Chiropractor | 6100 Primacy Pkwy, Suite 105, Memphis, TN 38119-0705 | 2006-08-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417469628 | Jojuan Fullwiley | Behavioral Analyst | 6685 Quince Rd Ste 116, Memphis, TN 38119 | 2017-10-27 |
| 1336675297 | Jill Budynas Depriest | Counselor | 5583 Murray Ave Ste 203, Memphis, TN 38119 | 2017-05-11 |
| 1396279220 | Glen Matthew Stamps Jr. | Counselor | 5583 Murray Ave Ste 207, Memphis, TN 38119 | 2017-04-18 |
| 1598117442 | Hazel Aberdeen | Chiropractor | 1911 Memphis Tennessee, Memphis, TN 38119 | 2016-07-04 |
| 1831569060 | E-c-t Non Emergency Medical Transport | Non-emergency Medical Transport (VAN) | 6869 Woodlake Dr, Memphis, TN 38119 | 2015-09-30 |
| 1053781617 | Astrid Roman | Dietitian, Registered | 8020 Hillside Cv, Memphis, MS 38119 | 2015-09-25 |
| 1467857664 | Allan Jacob Katz | Counselor | 5668 Rex Rd, Suite 104, Memphis, TN 38119 | 2014-10-30 |
| 1962836015 | Judy Ann Harrick | Acupuncturist | 5575 Poplar Ave., #702, Memphis, TN 38119 | 2013-08-26 |
| 1366791949 | Jennifer Denyes Bidelman | Audiologist | 5625 Poplar Avenue, Memphis, TN 38119 | 2012-08-29 |
| 1578833620 | Elizabeth Mary Dion-douglass | Pharmacist | 2891 Kirby Parkway, Memphis, TN 38119 | 2012-01-06 |
| Find all providers in zip 38119 | ||||
| Taxonomy Code | 207QS0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Sports Medicine |
| A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation. |
| 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 Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063936235 | Milligan College | Family Medicine | One Blowers Blvd., Athletics, Milligan College, TN 37682 | 2017-07-31 |
| 1205379989 | Elite Sports Medicine and Orthopaedic Center, Plc | Family Medicine | 356 24th Ave North, Nashville, TN 37203-1519 | 2016-11-29 |
| 1770915928 | Chattanooga Sports Institute | Family Medicine | 4206 N Access Rd, Chattanooga, TN 37415-3801 | 2013-07-30 |
| 1740527753 | Amg-hillside LLC | Family Medicine | 200 Hillside Dr, Pulaski, TN 38478-4566 | 2013-01-10 |
| 1265687917 | Chattanooga Family and Sports Medical Center, Pllc | Family Medicine | 6035 Shallowford Rd, Suite 101, Chattanooga, TN 37421-1688 | 2008-11-21 |
| 1841485018 | Crystal Shanelle Dyer | Family Medicine | 850 W Main St Ste 2, Rogersville, TN 37857-3663 | 2007-09-11 |
| 1053326876 | Laura N. Lendermon | Family Medicine | 9950 Crooked Creek Drive, Collierville, TN 38017 | 2006-07-30 |
| 1528097771 | Chris A Klenck | Family Medicine | 1551 Lake Loudon Blvd, Knoxville, TN 37996-2674 | 2006-07-01 |
| 1003881061 | Bill Moore Smith Jr. | Family Medicine | 632 Morrison Springs Road, Suite #202, Chattanooga, TN 37415 | 2006-02-22 |
| 1700860988 | James Norris Johnson | Family Medicine | 28 White Bridge Rd Ste 207, Nashville, TN 37205-1451 | 2005-12-01 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MEMPHIS PAIN MANAGEMENT GROUP, PC.
| 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.