SOUTHERN CARDIOVASCULAR PLLC
NPI 1447415104
Clinic/Center - Multi-Specialty in Memphis, TN
About Southern Cardiovascular Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUTHERN CARDIOVASCULAR PLLC (NPI 1447415104) is a healthcare organization registered as a multi-specialty in Memphis, Tennessee and active in the NPI registry since July 2008. The organization holds a CLIA Waiver certificate valid through February 1, 2027 and lists Jonathan Joe Ellichman, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Southern Cardiovascular Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
3Medicare enrollment records show 3 clinicians reassign Medicare billing to Southern Cardiovascular PLLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 3 within 10 miles. They are listed nearest first.
Clinicians, nearest first (3)
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 44D2090884
Southern Cardiovascular · Memphis, TNFrequently 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 Southern Cardiovascular PLLC's NPI number?
The NPI number for Southern Cardiovascular PLLC is 1447415104. It was assigned to this organization in the NPPES registry on July 22, 2008.
Where is Southern Cardiovascular PLLC located?
Southern Cardiovascular PLLC is located at 6401 Poplar Ave Ste 410, Memphis, TN 38119. The listed phone number is (901) 259-2718.
What is Southern Cardiovascular PLLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.
Is Southern Cardiovascular PLLC enrolled in Medicare?
Yes. Southern Cardiovascular PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Southern Cardiovascular PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Southern Cardiovascular PLLC, in Cardiac Surgery, Nurse Practitioner and Podiatry. 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, 1 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Southern Cardiovascular PLLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 44D2090884) is associated with this NPI, valid through February 1, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Southern Cardiovascular PLLC accept?
Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter of Alabama and Ambetter of Tennessee list Southern Cardiovascular PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Southern Cardiovascular PLLC was last updated on August 15, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.
# Southern Cardiovascular Pllc · NPI 1447415104
Multi-Specialty organization in Memphis, Tennessee. Organization record, active in the CMS NPPES registry since July 22, 2008.
## Identity
- **NPI:** 1447415104 (Entity type: Organization)
- **Enumerated:** July 22, 2008
- **Primary specialty:** Clinic/Center - Multi-Specialty · taxonomy 261QM1300X
- **Organization subpart:** No
- **Authorized official:** Jonathan Ellichman, PRESIDENT
## Practice location
- **Address:** 6401 POPLAR AVE STE 410, Memphis, TN 38119
- **Phone:** (901) 259-2718 · **Fax:** (901) 259-1123
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 3 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Cardiac Surgery (1), Nurse Practitioner (1), Podiatry (1); 1 practice at this address and 3 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 15, 2018
- **Other identifiers:** Medicaid 1526038 (TN)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1447415104) · Data from the CMS NPPES public registry.