MEMPHIS NUTRITION GROUP, LLC (NPI# 1538799515) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538799515 |
| Entity Type | Organization |
| Organization Name | MEMPHIS NUTRITION GROUP, LLC |
| Practice Address |
6263 Poplar Ave Ste 605 Memphis TN 38119-4724 |
| Practice Telephone | 9013436146 |
| Practice Fax Number | 9013281802 |
| Mailing Telephone | 9013436146 |
| Mailing Fax Number | 9013281802 |
| Enumeration Date | 2020-01-18 |
| Last Update Date | 2020-01-18 |
| Authorized Official Name | BLAIR MIZE (CO-OWNER) |
| Authorized Official Telephone | 9016191942 |
| Authorized Official Credential | MS, RDN, CSSD, L |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Street Address |
6263 POPLAR AVE STE 605 |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38119-4724 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629552633 | Leslie Carr Ely | Dietitian, Registered | 6263 Poplar Ave Ste 605, Memphis, TN 38119-4724 | 2018-09-17 |
| 1457959603 | Brigid Breedlove Kay | Dietitian, Registered | 6263 Poplar Ave Ste 605, Memphis, TN 38119-4724 | 2020-10-10 |
| 1336773654 | Caroline Frances Pruente | Dietitian, Registered | 6263 Poplar Ave Ste 605, Memphis, TN 38119-4724 | 2020-02-25 |
| 1174153159 | Blair Mize | Dietitian, Registered | 6263 Poplar Ave Ste 605, Memphis, TN 38119-4724 | 2020-01-18 |
| 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 | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366078669 | Np Cares, LLC | Clinic/Center | 4515 Poplar Ave Ste 131, Memphis, TN 38117-7503 | 2020-03-18 |
| 1326670555 | East Memphis Urgent Medical Clinic PC | Clinic/Center | 6515 Poplar Ave Ste 106, Memphis, TN 38119-4878 | 2020-02-05 |
| 1528557220 | The Conner T Medical Group Pllc | Clinic/Center | 3393 Kirby Rd, Memphis, TN 38115-4253 | 2018-05-08 |
| 1629567888 | David Wright LLC | Clinic/Center | 5100 Poplar Ave Ste 2716, Memphis, TN 38137-4000 | 2018-05-03 |
| 1376793653 | Eyecare for You LLC | Clinic/Center | 3964 Elvis Presley Blvd, Memphis, TN 38116-5831 | 2008-09-24 |
| 1780215509 | Nucor Family Clinic | Clinic/Center | 3601 Paul R Lowry Rd, Memphis, TN 38109-3007 | 2020-01-30 |
| 1699267260 | Nspyred Preventive Solutions, LLC | Clinic/Center | 3721 Riverdale Rd, Memphis, TN 38115-5322 | 2018-05-30 |
| 1679071906 | Better Body Memphis LLC | Clinic/Center | 1417 Monroe Ave, Memphis, TN 38104-3634 | 2018-02-01 |
| 1477078517 | Childress County Hospital District | Clinic/Center | 506 W Noel St, Memphis, TX 79245-3328 | 2017-08-10 |
| 1447678776 | Perisco Wofford Md Pllc | Clinic/Center | 4567 Millbranch Rd, Memphis, TN 38116-7437 | 2014-04-03 |
| 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.