DR. BASANAGOUD MUDIGOUDAR (NPI# 1528278223) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528278223 |
| Entity Type | Individual |
| Full Name | DR. BASANAGOUD MUDIGOUDAR |
| Credential | M.D. |
| Practice Address |
848 Adams Ave. Ste.l400 Memphis TN 38103 |
| Mailing Address |
850 Poplar Ave Bldg. 2 Memphis TN 38105 |
| Practice Telephone | 9012877337 |
| Practice Fax Number | 9012874540 |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2018-06-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0402X |
Psychiatry & Neurology Specialization: Neurology with Special Qualifications in Child Neurology |
48824 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 163872802 | 05 | |
| TX | 169935701 | 05 |
| Street Address |
848 ADAMS AVE. STE.L400 |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659337855 | James Wheless | Psychiatry & Neurology | 848 Adams Ave., Ste. L400, Memphis, TN 38105 | 2006-04-25 |
| 1912556895 | University of Tennessee | Dentist | 848 Adams Ave., Suite 101, Memphis, TN 38103-2816 | 2019-09-04 |
| 1740765940 | Haley Miranda Freeman | Nurse Practitioner | 848 Adams Ave., Ste. L400, Memphis, TN 38103 | 2018-10-03 |
| 1780169441 | Brianna Megan Dale | Nurse Practitioner | 848 Adams Ave., Ste. L400, Memphis, TN 38103 | 2018-09-28 |
| 1992287213 | Jessica Arean Pliego | Clinical Neuropsychologist | 848 Adams Ave., Ste. L400, Memphis, TN 38103 | 2018-09-04 |
| 1093024101 | Ut Lebonheur Pediatric Specialists, Inc. | Dermatology | 848 Adams Ave., Memphis, TN 38103 | 2010-10-07 |
| 1184870958 | Namrata Samir Shah | Psychiatry & Neurology | 848 Adams Ave., Ste. L400, Memphis, TN 38103 | 2008-08-13 |
| 1649309394 | Robin Lynne Jack | Psychiatry & Neurology | 848 Adams Ave., Ste. L400, Memphis, TN 38103 | 2007-03-05 |
| 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 | 2084N0402X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology with Special Qualifications in Child Neurology |
| A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629369475 | Amy Law Patterson | Psychiatry & Neurology | 848 Adams Ave Ste L400, Memphis, TN 38103-2816 | 2011-04-27 |
| 1659337855 | James Wheless | Psychiatry & Neurology | 848 Adams Ave., Ste. L400, Memphis, TN 38105 | 2006-04-25 |
| 1598152928 | Andrew Charles Schroeder | Psychiatry & Neurology | 848 Adams Ave Ste L400, Memphis, TN 38103-2816 | 2015-04-23 |
| 1316387095 | Nitish Chourasia | Psychiatry & Neurology | 848 Adams Ave Ste L400, Memphis, TN 38103-2816 | 2013-06-26 |
| 1609115872 | Farid Ud Din | Psychiatry & Neurology | 848 Adams Ave, L400, Memphis, TN 38103-2816 | 2013-02-07 |
| 1831423607 | Marianna Rivas-coppola | Psychiatry & Neurology | 848 Adams Ave, Suite L400, Memphis, TN 38103-2816 | 2009-09-28 |
| 1184870958 | Namrata Samir Shah | Psychiatry & Neurology | 848 Adams Ave., Ste. L400, Memphis, TN 38103 | 2008-08-13 |
| 1386811891 | Kathleen Nicole Montinola Jalandoni | Psychiatry & Neurology | 1407 Union Ave, Suite 1400, Memphis, TN 38104-3627 | 2008-05-14 |
| 1407021389 | Sarah E Weatherspoon | Psychiatry & Neurology | 848 Adams Ave, L400, Memphis, TN 38103 | 2008-04-23 |
| 1356544340 | Elena Caron | Psychiatry & Neurology | 848 Adams Ave, Suite L400, Memphis, TN 38103-2816 | 2007-06-07 |
| 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.