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UT MEDICAL GROUP, INC,
NPI 1154675072
General Acute Care Hospital - Children in Memphis, TN

Active since October 30, 2012CLIA Certified · 2 labs
877 JEFFERSON AVE, MEMPHIS, TN 38103(901) 545-7366 Get Directions Write a Review

NPPES record last updated: October 30, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Ut Medical Group, Inc, NPPES

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

UT MEDICAL GROUP, INC, (NPI 1154675072) is a healthcare organization registered as a children in Memphis, Tennessee and active in the NPI registry since October 2012. The organization holds 2 active CLIA laboratory certificates and lists Richard O. Baer, Chief Operating Officer, as its authorized official.

NPPES Registry Identity

NPI1154675072
Entity TypeOrganization
Primary Taxonomy282NC2000X
Legal Business NameUT MEDICAL GROUP, INC,
Location Address877 JEFFERSON AVEMemphis, TN 38103-2807
Mailing Address1407 Union Ave, Suite 640Memphis, TN 38104-3627 · (901) 866-8372 · Fax (901) 302-2360
Phone(901) 545-7366
Organization SubpartNo
Authorized OfficialRichard O. BaerChief Operating Officer · (901) 866-8372
Enumeration DateOctober 30, 2012
✔ NPI 1154675072 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral Acute Care Hospital · ChildrenHospitals
Taxonomy Code282NC2000X
License✔ Licensed in TN · 15537
877 JEFFERSON AVE, Memphis, TN 38103
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CLIA Laboratory Certificates CMS CLIA 2

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 Accreditation 44D2091956

Ut Medical Group, Inc Dba Utmg Pathology, LLC · Memphis, TN
Active · expires Jul 8, 2027
CLIA Number44D2091956
Laboratory TypeIndependent
Certificate Effective DateJuly 9, 2025
Certificate Expiration DateJuly 8, 2027
Laboratory DirectorDr. Cameila D. Johns
Laboratory Phone(901) 866-8519
Laboratory LocationUt Medical Group, Inc Dba Utmg Pathology, LLC877 Jefferson Ave, Chandler Building, 4th Fl & Basement, Memphis, TN 38103
CLIA data matches this NPI record on: Address Name
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Certificate of Accreditation 44D2090400

Ut Medical Group, Inc Dba Utmg Pathology, LLC · Memphis, TN
Active · expires Mar 25, 2027
CLIA Number44D2090400
Laboratory TypeIndependent
Certificate Effective DateMarch 26, 2025
Certificate Expiration DateMarch 25, 2027
Laboratory DirectorDr. Twisha H. Oza
Laboratory Phone(901) 866-8519
Laboratory LocationUt Medical Group, Inc Dba Utmg Pathology, LLC930 Madison Ave, 5th Floor, 544A And 545A, Memphis, TN 38103
CLIA data matches this NPI record on: Name
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MIMILY HARSONO MD
Pediatrics (Neonatal-Perinatal Medicine)
877 JEFFERSON AVE
MEMPHIS, TN 38103
Shelby County (901) 545-7100
JESSICA DORAN DNP, CRNA
Nurse Anesthetist, Certified Registered
877 JEFFERSON AVE
MEMPHIS, TN 38103
Shelby County (901) 448-5893
SHELBY COUNTY HEALTH CARE CORPORATION
Skilled Nursing Facility
877 JEFFERSON AVE, 3RD FLOOR, ADAMS PAVILION
MEMPHIS, TN 38103
Shelby County (901) 515-4300
EDSON RUIZ MD
Pediatrics (Neonatal-Perinatal Medicine)
877 JEFFERSON AVE
MEMPHIS, TN 38103
Shelby County (901) 448-5950
MS. MARLA GIDDENS CRNA
Nurse Anesthetist, Certified Registered
877 JEFFERSON AVE
MEMPHIS, TN 38103
Shelby County (901) 545-7100
MARY BETH HALL-KRASNOVE FNP
Nurse Practitioner (Family)
877 JEFFERSON AVE
MEMPHIS, TN 38103
Shelby County (901) 545-8090
MEGAN TALLEY
Dietitian, Registered
877 JEFFERSON AVE
MEMPHIS, TN 38103
Shelby County (901) 545-7753
COURTNEY H PARKER CRNA
Nurse Anesthetist, Certified Registered
877 JEFFERSON AVE
MEMPHIS, TN 38103
Shelby County (901) 545-7100

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 Ut Medical Group, Inc,'s NPI number?

The NPI number for Ut Medical Group, Inc, is 1154675072. It was assigned to this organization in the NPPES registry on October 30, 2012.

Where is Ut Medical Group, Inc, located?

Ut Medical Group, Inc, is located at 877 Jefferson Ave, Memphis, TN 38103. The listed phone number is (901) 545-7366.

What is Ut Medical Group, Inc,'s specialty?

The primary specialty registered for this NPI is General Acute Care Hospital, specializing in Children, with taxonomy code 282NC2000X.

Does Ut Medical Group, Inc, hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Ut Medical Group, Inc, was last updated on October 30, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years 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.