1457317224 NPI number — SHIRLEY PRICE BARNES M.D.

Table of content: (NPI 1770804072)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457317224 NPI number — SHIRLEY PRICE BARNES M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PRICE BARNES
Provider First Name:
SHIRLEY
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1457317224
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/05/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
350 N HUMPHREYS BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MEMPHIS
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
38120-2177
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
901-226-4003
Provider Business Mailing Address Fax Number:
901-227-8591

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1995 HIGHWAY 51 S STE 204
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COVINGTON
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38019-3655
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
901-475-5305
Provider Business Practice Location Address Fax Number:
901-475-5307
Provider Enumeration Date:
04/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  E-2722 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: 49146 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 142887001 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1888800000 . This is a "QUAL CHOICE" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: 0100495 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: 49146 . This is a "MEDICAL LICENSE" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 5L684 . This is a "MEDICARE" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: 1530140 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: H30752 . This is a "UPIN" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".




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