DR. JERRY LEE LOVELACE JR. (NPI# 1568571404) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568571404 |
| Entity Type | Individual |
| Full Name | DR. JERRY LEE LOVELACE JR. |
| Credential | M.D. |
| Practice Address |
1488 Madison Ave Memphis TN 38104-2447 |
| Practice Telephone | 9017264110 |
| Practice Fax Number | 9017264106 |
| Mailing Telephone | 9017264110 |
| Mailing Fax Number | 9017264106 |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2013-01-28 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208D00000X | General Practice | 226835 | NY | Allopathic & Osteopathic Physicians |
| Y | 208D00000X | General Practice | 39486 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 3335622 | 05 |
| Street Address |
1488 MADISON AVE |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38104-2447 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043470131 | Sherry Bougard | Counselor | 1488 Madison Ave, Memphis, TN 38104-2447 | 2008-06-11 |
| 1154461218 | Midtown Injury & Physical Therapy Center P.C. | General Practice | 1488 Madison Ave, Memphis, TN 38104-2447 | 2007-02-07 |
| 1558401521 | Angela Renee Washington | Physical Medicine & Rehabilitation | 1488 Madison Ave, Memphis, TN 38104-2447 | 2007-02-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952900367 | Christy White | Recreation Therapist | 1030 Jefferson Ave (rt117), Memphis, TN 38104 | 2020-10-19 |
| 1821615873 | Altiana Carter | Optometrist | 650 New York St, Memphis, Tn 38104, Memphis, TN 38104 | 2020-06-25 |
| 1952898413 | Family To Family Adult Care Service | Chore Provider | 1331 Union Ave Suite 1028, Mempnis, TN 38104 | 2018-04-19 |
| 1326544800 | Kimberly Vestoria Mcclinton | Nurse Practitioner | 2200 Union Ave 1, Memphis, TN 38104 | 2018-04-03 |
| 1649799339 | Benjamin Duhart Jr. | Pharmacist | 1265 Union Avenue- Methodist University Hospital, Ground Floor Pharmacy Administration, Memphis, TN 38104 | 2017-09-13 |
| 1134644982 | Amy Michelle Wise | Nurse Practitioner | 1325 Eastmoreland Ave Ste 500, Memphis, TN 38104 | 2017-08-13 |
| 1316468572 | Jinger Cathey | Social Worker | 1330 Jefferson Ave, Memphis, TN 38104 | 2017-06-28 |
| 1336669183 | Charma May Kavuncu | Social Worker | 1407 Union Ave Ste 1100, Memphis, TN 38104 | 2017-06-22 |
| 1003345398 | Angelica J Dennis | Nurse Practitioner | 1265 Union, Memphis, TN 38104 | 2017-06-08 |
| 1609302546 | Cheryl Beene | Nurse Practitioner | 1211 Union Ave Ste 475, Memphis, TN 38104 | 2017-05-11 |
| Find all providers in zip 38104 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942609045 | Midsouth Neuropathy Treatment Center | General Practice | 1052 Brookfield Rd, Suite 101, Memphis, TN 38119-3860 | 2014-08-14 |
| 1528488699 | Sheg Oluwaseun Aranmolate | General Practice | 1926 Foster Ave, Memphis, TN 38114-2003 | 2014-04-16 |
| 1538588827 | Chs Tennessee Medical, P.C. | General Practice | 4740 Burbank Rd, Memphis, TN 38118-6301 | 2014-04-15 |
| 1629493424 | Maximum Health and Wellness LLC | General Practice | 6094 Apple Tree Dr, Suite 6, Memphis, TN 38115-0308 | 2014-03-03 |
| 1497064653 | Wellness Evaluation Services, Inc | General Practice | 1061 W Rex Rd, Memphis, TN 38119-3819 | 2010-10-05 |
| 1861719445 | Total Heatlh Care | General Practice | 4299 Elvis Presley B;vd., Memphis, TN 38116-6435 | 2010-04-22 |
| 1508038910 | F Chin, Inc | General Practice | 5347 Dunnellon Ave, Memphis, TN 38134-5305 | 2008-03-25 |
| 1295863488 | Daniel P Marshall | General Practice | 515 N Highland St, Memphis, TN 38122-4572 | 2007-03-01 |
| 1891842696 | John Goodfred | General Practice | 3965 S Mendenhall Rd Ste 6, Memphis, TN 38115-5914 | 2007-01-04 |
| 1013004324 | Mark L Reed | General Practice | 3789 Covington Pike, Memphis, TN 38135-2279 | 2006-10-06 |
| 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.