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PROFESSIONAL ASSOCIATION
NPI 1366416653
Dermatology in Memphis, TN

Active since February 14, 2006CLIA Certified · 3 labs
1455 UNION AVE, MEMPHIS, TN 38104(901) 726-6655(901) 726-9056 Get Directions Write a Review

NPPES record last updated: April 15, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Professional Association NPPES

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

PROFESSIONAL ASSOCIATION (NPI 1366416653) is a healthcare organization registered as a dermatology in Memphis, Tennessee and active in the NPI registry since February 2006. The organization holds 3 active CLIA laboratory certificates and lists Lynn Harris, Administrative Assistant, as its authorized official.

NPPES Registry Identity

NPI1366416653
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameMEMPHIS DERMATOLOGY CLINIC PA
Location Address1455 UNION AVEMemphis, TN 38104-6727
Mailing Address1455 Union AveMemphis, TN 38104-6727 · (901) 726-6655 · Fax (901) 726-9056
Phone(901) 726-6655
Fax(901) 726-9056
Organization SubpartNo
Authorized OfficialLynn HarrisAdministrative Assistant · (901) 726-6655
Enumeration DateFebruary 14, 2006
Last NPPES UpdateApril 15, 2024
NPPES CertifiedApril 15, 2024
✔ NPI 1366416653 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
1455 UNION AVE, Memphis, TN 38104
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Other Names 1

Other NameProfessional Association

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 3

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 Compliance 44D0313797

Memphis Dermatology Clinic, PA · Memphis, TN
Active · expires Mar 9, 2027
CLIA Number44D0313797
Laboratory TypePhysician Office
Certificate Effective DateMarch 10, 2025
Certificate Expiration DateMarch 9, 2027
Laboratory DirectorDr. Frances K. Lawhead
Laboratory Phone(901) 726-6655
Laboratory LocationMemphis Dermatology Clinic, PA1455 Union Avenue, Memphis, TN 38104
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 44D2191360

Memphis Dermatology Clinic, PA · Memphis, TN
Active · expires Apr 7, 2028
CLIA Number44D2191360
Laboratory TypePhysician Office
Certificate Effective DateApril 8, 2026
Certificate Expiration DateApril 7, 2028
Laboratory DirectorDr. Frances K. Lawhead
Laboratory Phone(901) 726-6655
Laboratory LocationMemphis Dermatology Clinic, PA795 Ridge Lake Blvd, #200, Memphis, TN 38120
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 44D1096679

Memphis Dermatology Clinic, PA · Memphis, TN
Active · expires Sep 9, 2027
CLIA Number44D1096679
Laboratory TypePhysician Office
Certificate Effective DateSeptember 10, 2025
Certificate Expiration DateSeptember 9, 2027
Laboratory DirectorDr. Frances K. Lawhead
Laboratory Phone(901) 726-6655
Laboratory LocationMemphis Dermatology Clinic, PA1451 Union Avenue, Memphis, TN 38104
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 10

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

DR. EMILY T. OVERHOLSER M.D.
Dermatology
1455 UNION AVE
MEMPHIS, TN 38104
Shelby County (901) 726-6655
DR. COURTNEY STROUPE WOODMANSEE MD
Dermatology (MOHS-Micrographic Surgery)
1455 UNION AVE
MEMPHIS, TN 38104
Shelby County (901) 726-6655
LESLIE ELAINE GRAHAM DNP, AGNP-C
Nurse Practitioner
1455 UNION AVE
MEMPHIS, TN 38104
Shelby County (901) 726-6655
MS. AMY A HUBER MD
Dermatology (MOHS-Micrographic Surgery)
1455 UNION AVE
MEMPHIS, TN 38104
Shelby County (901) 726-6655
MR. REX ALLEN AMONETTE MD
Dermatology (Dermatopathology)
1455 UNION AVE
MEMPHIS, TN 38104
Shelby County (901) 726-6655
MRS. MARY ELIZABETH STEPHENS NP-C
Nurse Practitioner (Family)
1455 UNION AVE
MEMPHIS, TN 38104
Shelby County (901) 726-6655
MR. FRANK GLOVER WITHERSPOON JR. MD
Dermatology (Dermatopathology)
1455 UNION AVE
MEMPHIS, TN 38104
Shelby County (901) 726-6655
MR. JOHN HARVEY GARDNER MD
Dermatology (MOHS-Micrographic Surgery)
1455 UNION AVE
MEMPHIS, TN 38104
Shelby County (901) 726-6655

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 Memphis Dermatology Clinic PA's NPI number?

The NPI number for Memphis Dermatology Clinic PA is 1366416653. It was assigned to this organization in the NPPES registry on February 14, 2006. The provider is also known as Professional Association.

Where is Memphis Dermatology Clinic PA located?

Memphis Dermatology Clinic PA is located at 1455 Union Ave, Memphis, TN 38104. The listed phone number is (901) 726-6655.

What is Memphis Dermatology Clinic PA's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Does Memphis Dermatology Clinic PA hold CLIA laboratory certificates?

Yes. 3 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 Memphis Dermatology Clinic PA was last updated on April 15, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.