NPI Code Details Logo

NPI 1376541409

NPI 1376541409 : MSK GROUP, PC : MEMPHIS, TN

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1376541409
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    MSK GROUP, PC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    07/12/2005
-----------------------------------------------------
    Last Update Date     |    10/21/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    6286 BRIARCREST AVE STE 200 
-----------------------------------------------------
    City                 |    MEMPHIS
-----------------------------------------------------
    State                |    TN
-----------------------------------------------------
    Zip                  |    38120-4023
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    901-259-1600
-----------------------------------------------------
    Fax                  |    901-259-1698
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    6077 PRIMACY PKWY STE 140 
-----------------------------------------------------
    City                 |    MEMPHIS
-----------------------------------------------------
    State                |    TN
-----------------------------------------------------
    Zip                  |    38119-5754
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    901-641-3000
-----------------------------------------------------
    Fax                  |    901-701-2400
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    C.E.O.
-----------------------------------------------------
    Name                 |    MR. KIM  JENKINS 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    901-641-3000
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    225X00000X
-----------------------------------------------------
    Taxonomy Name        |    Occupational Therapist
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    363AS0400X
-----------------------------------------------------
    Taxonomy Name        |    Surgical Physician Assistant
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
    Taxonomy Code        |    2081P2900X
-----------------------------------------------------
    Taxonomy Name        |    Pain Medicine (Physical Medicine & Rehabilitation) Physician
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
    Taxonomy Code        |    363LF0000X
-----------------------------------------------------
    Taxonomy Name        |    Family Nurse Practitioner
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #5
-----------------------------------------------------
    Taxonomy Code        |    208100000X
-----------------------------------------------------
    Taxonomy Name        |    Physical Medicine & Rehabilitation Physician
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #6
-----------------------------------------------------
    Taxonomy Code        |    225100000X
-----------------------------------------------------
    Taxonomy Name        |    Physical Therapist
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #7
-----------------------------------------------------
    Taxonomy Code        |    225200000X
-----------------------------------------------------
    Taxonomy Name        |    Physical Therapy Assistant
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #8
-----------------------------------------------------
    Taxonomy Code        |    363LA2200X
-----------------------------------------------------
    Taxonomy Name        |    Adult Health Nurse Practitioner
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #9
-----------------------------------------------------
    Taxonomy Code        |    207XS0106X
-----------------------------------------------------
    Taxonomy Name        |    Orthopaedic Hand Surgery Physician
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #10
-----------------------------------------------------
    Taxonomy Code        |    207XX0005X
-----------------------------------------------------
    Taxonomy Name        |    Sports Medicine (Orthopaedic Surgery) Physician
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #11
-----------------------------------------------------
    Taxonomy Code        |    225XH1200X
-----------------------------------------------------
    Taxonomy Name        |    Hand Occupational Therapist
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #12
-----------------------------------------------------
    Taxonomy Code        |    207X00000X
-----------------------------------------------------
    Taxonomy Name        |    Orthopaedic Surgery Physician
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.