MOSAIC PRIME (NPI# 1548479801) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548479801 |
| Entity Type | Organization |
| Organization Name | MOSAIC PRIME |
| Practice Address |
20 Dudley St Suite 250 Memphis TN 38103-4904 |
| Mailing Address |
1318 Marsh Creek Ln Collierville TN 38017-3940 |
| Practice Telephone | 9018661655 |
| Practice Fax Number | 8663598798 |
| Mailing Telephone | 9015686009 |
| Mailing Fax Number | 8663598798 |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2015-11-17 |
| Authorized Official Name | DR. JULIA DAHL (CHIEF MEDICAL OFFICER) |
| Authorized Official Telephone | 9015686009 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | 44D1053242 | TN | Laboratories |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | CLIA CERTIFICATION LAB | 44D1053242 | 01 |
| Street Address |
20 DUDLEY ST SUITE 250 |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38103-4904 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386052249 | Cquentia Labs, LLC | Clinical Medical Laboratory | 20 Dudley St, #420, Memphis, TN 38103-4904 | 2014-07-23 |
| 1790035608 | Stephan Wade Morris | Internal Medicine | 20 Dudley St, C/o Memphis Bioworks Foundation - Suite 900, Memphis, TN 38103-4904 | 2012-09-18 |
| 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 | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366065005 | Neovect Technologies, LLC | Clinical Medical Laboratory | 287 Wilkinson Pl, Memphis, TN 38111-6125 | 2020-05-27 |
| 1164910758 | Urban Alpha | Clinical Medical Laboratory | 6286 Quince Rd, Memphis, TN 38119-7629 | 2018-04-29 |
| 1205355377 | Cquentia Ngs, LLC | Clinical Medical Laboratory | 3742 Tyndale Dr, Memphis, TN 38125-8500 | 2017-09-11 |
| 1124442306 | Total Diagnostix II, LLC | Clinical Medical Laboratory | 3740 Business Dr Ste 101, Memphis, TN 38125-3971 | 2014-02-10 |
| 1114286523 | Quest Diagnostics Tb LLC | Clinical Medical Laboratory | 5846 Distribution Dr, Memphis, TN 38141-8203 | 2012-05-07 |
| 1124202668 | Priority Sleep Diagnostic Center LLC | Clinical Medical Laboratory | 3650 Southwind Park Cove, Suite 104, Memphis, TN 38125 | 2007-12-19 |
| 1144429929 | Concentra Laboratory LLC | Clinical Medical Laboratory | 3560 Air Center Cv, Suite 101, Memphis, TN 38118-3626 | 2007-07-12 |
| 1770622177 | Silicone Ocular | Clinical Medical Laboratory | 6 W Ge Patterson Ave, Suite 101, Memphis, TN 38103-6413 | 2007-02-05 |
| 1669518221 | Memphis Clinical Laboratory Inc | Clinical Medical Laboratory | 4088 Barton Dr, Memphis, TN 38116-5821 | 2007-01-30 |
| 1790831857 | Memphis Sleep Diagnostics | Clinical Medical Laboratory | 2542 Ridgeway Rd, Suite 9, Memphis, TN 38119-7422 | 2007-01-25 |
| 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.