DR. ILYSE SAMANTHA KORNBLAU (NPI# 1720407372) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720407372 |
| Entity Type | Individual |
| Full Name | DR. ILYSE SAMANTHA KORNBLAU |
| Credential | MD |
| Practice Address |
262 Danny Thomas Pl Memphis TN 38105-3678 |
| Mailing Address |
262 Danny Thomas Pl # Ms 515 Memphis TN 38105-3678 |
| Practice Telephone | 8882264343 |
| Enumeration Date | 2014-04-10 |
| Last Update Date | 2019-07-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 582279 | TX | Allopathic & Osteopathic Physicians |
| Y | 207W00000X | Ophthalmology | 59116 | TN | Allopathic & Osteopathic Physicians |
| N | 207W00000X | Ophthalmology | HSE26017 | FL | Allopathic & Osteopathic Physicians |
| N | 207W00000X | Ophthalmology | BP20054251 | TX | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1 Baylor Plz, Bcm 620, Houston, TX 770303411 | 7137984260 | 4097475412 |
| Street Address |
262 DANNY THOMAS PL |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38105-3678 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861495889 | Melissa M Hudson | Pediatrics | 262 Danny Thomas Pl, Memphis, TN 38105-3678 | 2005-05-23 |
| 1023618907 | James Michael Burgess | Registered Nurse | 262 Danny Thomas Pl, Memphis, TN 38105-3678 | 2020-10-29 |
| 1669098273 | Cassandra Gerhart | Nurse Anesthetist, Certified Registered | 262 Danny Thomas Pl, Memphis, TN 38105-3678 | 2020-06-19 |
| 1275152589 | Katherine Farabee Bailey | Registered Nurse | 262 Danny Thomas Pl, Memphis, TN 38105-3678 | 2020-04-16 |
| 1144851858 | Chs Tennessee Medical P C | Clinic/Center | 262 Danny Thomas Pl, Memphis, TN 38105-3678 | 2020-01-31 |
| 1285274639 | Alise Murray | Genetic Counselor, MS | 262 Danny Thomas Pl, Memphis, TN 38105-3678 | 2020-01-14 |
| 1053951566 | Mary Margaret Benson | Nurse Practitioner | 262 Danny Thomas Pl, Memphis, TN 38105-3678 | 2020-01-13 |
| 1164062071 | Erma Louise Davis | Nurse Practitioner | 262 Danny Thomas Pl, Memphis, TN 38105-3678 | 2020-01-08 |
| 1821637216 | Heather Gaye Havens | Nurse Practitioner | 262 Danny Thomas Pl, Memphis, TN 38105-3678 | 2020-01-02 |
| 1811534837 | Cody Elizabeth Mcmillan | Nurse Practitioner | 262 Danny Thomas Pl, Memphis, TN 38105-3678 | 2019-12-09 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447887435 | Leeanne Chittom Mcdonald | Dietitian, Registered | Ulps Surgery, 2nd Floor, 50 N. Dunlap, Memphis, TN 38105 | 2020-03-27 |
| 1619508942 | Victoria Mackay | Physician Assistant | 595 Danny Thomas Place, Memphis, TN 38105 | 2020-01-27 |
| 1720436710 | Angela Marie Pratt | Nurse Practitioner | 262 Danny Thomas Blvd, Memphis, TN 38105 | 2016-05-31 |
| 1326434465 | Amanda Green | Pediatrics | 262 N Danny Thomas Blvd # Ms 320, Memphis, TN 38105 | 2015-04-15 |
| 1467864173 | Nicole Mary Alberts | Psychologist | 262 Danny Thomas Place, Mail Stop 740, Department of Psychology, St Jude Children's Research H, Memphis, TN 38105 | 2014-05-29 |
| 1689004160 | Virginia Carney | Dietitian, Registered | 262 Danny Thomas Place - Mail Stop 732, Memphis, TN 38105 | 2013-11-19 |
| 1447506365 | Nickhill Hitesh Bhakta | Pediatrics | 262 Danny Thomas Way, Ms 721, Memphis, TN 38105 | 2012-07-29 |
| 1457622235 | Healthy Indigent Populations Inc. | Exclusive Provider Organization | 1066 Delmar, Memphis, TN 38105 | 2012-01-25 |
| 1285953265 | Nicholas Steve Phillips | Student in an Organized Health Care Education/Training Program | 262 Danny Thomas Place, Mail Stop 735, Memphis, TN 38105 | 2010-05-31 |
| 1205151776 | Kyle Joseph Morgan | Anesthesiology | 262 Danny Thomas Pl Dept Of, Memphis, TN 38105 | 2010-03-28 |
| Find all providers in zip 38105 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447606454 | Stephen Dryden | Ophthalmology | 930 Madison Ave Ste 470, Memphis, TN 38103-7400 | 2016-05-09 |
| 1609185891 | Duncan Eye Pllc | Ophthalmology | 653 S Willett St, Memphis, TN 38104-4932 | 2010-10-05 |
| 1275842197 | Kathleen Shirley Stern | Ophthalmology | 655 S Riverside Dr Apt 1103, Memphis, TN 38103-4615 | 2010-09-27 |
| 1083865232 | Memphis Retina Pllc | Ophthalmology | 1264 Wesley Dr Ste 302, Memphis, TN 38116-6445 | 2008-10-07 |
| 1205021227 | Clifford W Sims Md PC | Ophthalmology | 1407 Union Ave Ste 1003, Memphis, TN 38104-3678 | 2007-09-12 |
| 1235335118 | Shiva Bohn | Ophthalmology | 930 Madison Ave #400, Memphis, TN 38103 | 2007-06-26 |
| 1578684007 | Philip Marvin Furr | Ophthalmology | 555 Perkins Ext, Ste 430, Memphis, TN 38117-4410 | 2007-04-02 |
| 1538216239 | William C Hurd | Ophthalmology | 220 S Claybrook St Ste 101, Memphis, TN 38104-3538 | 2007-01-04 |
| 1023170925 | Clifford William Sims | Ophthalmology | 1407 Union Ave Ste 901, Memphis, TN 38104-3672 | 2006-12-15 |
| 1487724498 | Thomas Pratt | Ophthalmology | 5169 Wheelis Dr, Memphis, TN 38117-4519 | 2006-11-08 |
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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.