WELLNESS ONE MEMPHIS PC
NPI 1124497730
Family Medicine - Sports Medicine in Memphis, TN

Q: What is Wellness One Memphis PC's NPI number?

The NPI number for Wellness One Memphis PC is 1124497730. It was assigned to this organization in the NPPES registry on September 24, 2015.

Q: What is Wellness One Memphis PC's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

Active since September 24, 2015CLIA 44D2022894 · Waiver

6100 PRIMACY PKWY STE 112, MEMPHIS, TN 38119(901) 682-5335(901) 682-5440 Get Directions Write a Review

NPPES record last updated: July 25, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Wellness One Memphis Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WELLNESS ONE MEMPHIS PC (NPI 1124497730) is a healthcare organization registered as a sports medicine in Memphis, Tennessee and active in the NPI registry since September 2015. The organization holds a CLIA Waiver certificate valid through April 11, 2027 and lists Russell D Radican, President, as its authorized official.

NPPES Registry Identity

NPI1124497730

Entity TypeOrganization

Primary Taxonomy207QS0010X

Legal Business NameWELLNESS ONE MEMPHIS PC

Location Address6100 PRIMACY PKWY STE 112Memphis, TN 38119-0705

Mailing Address6100 Primacy Pkwy Ste 112Memphis, TN 38119-0705 · (901) 682-5335 · Fax (901) 682-5440

Phone(901) 682-5335

Fax(901) 682-5440

Organization SubpartNo

Authorized OfficialRussell D RadicanPresident · (901) 682-5335

Enumeration DateSeptember 24, 2015

Last NPPES UpdateJuly 25, 2025

NPPES CertifiedJuly 25, 2025

✔ NPI 1124497730 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyFamily Medicine · Sports MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207QS0010X

Definition

A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.

Also ListedChiropractorTaxonomy 111N00000X

Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X

6100 PRIMACY PKWY STE 112, Memphis, TN 38119

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Wellness One Memphis Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 3 clinicians reassign Medicare billing to Wellness One Memphis PC, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

Rebecca Novick, NP

Nurse Practitioner

NPI 1114331097

80 HUMPHREYS CENTER DR STE 330
Memphis, TN 38120

(901) 752-6131

✔ PECOS2.3 mi

Timothy Callaghan, M.D.

Family Practice

NPI 1548476252

9155 POPLAR AVE STE 27
Germantown, TN 38138

(888) 714-0072

✔ PECOS✔ Accepts Medicare6.2 mi

Amy White, CNM

Nurse Practitioner

NPI 1407358039

447 CAMILLE RD
Coldwater, MS 38618

(901) 233-9070

✔ PECOS✔ Accepts Medicare30 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 44D2022894

Wellness One Memphis, PC · Memphis, TN

Active · expires Apr 11, 2027

CLIA Number44D2022894

Laboratory TypePhysician Office

Certificate Effective DateApril 12, 2025

Certificate Expiration DateApril 11, 2027

Laboratory DirectorRussell D. Radican

Laboratory Phone(901) 682-5335

Laboratory LocationWellness One Memphis, PC6100 Primacy Pkwy Ste 112, Memphis, TN 38119

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Wellness One Memphis PC's NPI number?

The NPI number for Wellness One Memphis PC is 1124497730. It was assigned to this organization in the NPPES registry on September 24, 2015.

Where is Wellness One Memphis PC located?

Wellness One Memphis PC is located at 6100 Primacy Pkwy Ste 112, Memphis, TN 38119. The listed phone number is (901) 682-5335.

What is Wellness One Memphis PC's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

Is Wellness One Memphis PC enrolled in Medicare?

Yes. Wellness One Memphis PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Wellness One Memphis PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Wellness One Memphis PC, in Family Practice and Nurse Practitioner. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Wellness One Memphis PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 44D2022894) is associated with this NPI, valid through April 11, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Wellness One Memphis PC was last updated on July 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.