UNIVERSITY OF TN CYTOGENETICS LAB-MEMPHIS (NPI# 1770798332) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770798332 |
| Entity Type | Organization |
| Organization Name | UNIVERSITY OF TN CYTOGENETICS LAB-MEMPHIS |
| Practice Address |
711 Jefferson Ave Suite 523 Memphis TN 38105-5003 |
| Practice Telephone | 9014486676 |
| Practice Fax Number | 9014484117 |
| Mailing Telephone | 9014486676 |
| Mailing Fax Number | 9014484117 |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. AVIRACHAN THARAPEL (DIRECTOR, CYTOGENETICS LABORATORY) |
| Authorized Official Telephone | 9014486676 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | 0000002103 | TN | Laboratories |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 3402016 | 05 |
| Street Address |
711 JEFFERSON AVE SUITE 523 |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38105-5003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215921226 | Ronald Rafael Espinal | Pediatrics | 711 Jefferson Ave, Memphis, TN 38105-5003 | 2005-09-06 |
| 1043822711 | Alexandra Marie Vohs | Psychologist | 711 Jefferson Ave, Memphis, TN 38105-5003 | 2020-08-23 |
| 1487276523 | Shana Jen Crispin | Social Worker | 711 Jefferson Ave, Memphis, TN 38105-5003 | 2020-05-12 |
| 1699305102 | Elizabeth Adams | Psychologist | 711 Jefferson Ave, Memphis, TN 38105-5003 | 2020-01-23 |
| 1023677028 | Katherine Eileen O'bar | Dietitian, Registered | 711 Jefferson Ave, Memphis, TN 38105-5003 | 2019-06-12 |
| 1659831451 | Philip A Norfolk | Psychologist | 711 Jefferson Ave, Memphis, TN 38105-5003 | 2019-03-20 |
| 1780140376 | Takiiah Parker | Behavioral Analyst | 711 Jefferson Ave, Memphis, TN 38105-5003 | 2019-02-19 |
| 1811467731 | Jessica M James | Behavior Technician | 711 Jefferson Ave, Memphis, TN 38105-5003 | 2018-12-04 |
| 1619472065 | Jaime Tolleth | Behavioral Analyst | 711 Jefferson Ave, Memphis, TN 38105-5003 | 2018-03-28 |
| 1255849691 | Michelle Elizabeth Pleasant | Behavior Technician | 711 Jefferson Ave, Memphis, TN 38105-5003 | 2018-01-19 |
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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 |
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| 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 |
| 1548479801 | Mosaic Prime | Clinical Medical Laboratory | 20 Dudley St, Suite 250, Memphis, TN 38103-4904 | 2007-05-22 |
| 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 |
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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.