SOUTHERN CARDIOVASCULAR PLLC
NPI 1447415104
Clinic/Center - Multi-Specialty in Memphis, TN

Active since July 22, 2008CLIA 44D2090884 · Waiver
6401 POPLAR AVE STE 410, MEMPHIS, TN 38119(901) 259-2718(901) 259-1123 Get Directions Write a Review

NPPES record last updated: August 15, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Aug 15, 2018, Oct 2, 2015 (2 updates tracked since 2015).

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

NPI1447415104
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NameSOUTHERN CARDIOVASCULAR PLLC
Location Address6401 POPLAR AVE STE 410Memphis, TN 38119
Mailing AddressPo Box 1135Collierville, TN 38027-1135 · (901) 259-2718 · Fax (901) 259-1123
Fax(901) 259-1123
Organization SubpartNo
Authorized OfficialJonathan Joe EllichmanPresident · (901) 259-2718
Enumeration DateJuly 22, 2008
Last NPPES UpdateAugust 15, 20182 updates tracked since enumeration
NPI 1447415104 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
6401 POPLAR AVE STE 410, Memphis, TN 38119

Other Identifiers 1

Medicaid1526038TN

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, TN
Active · expires Feb 1, 2027
CLIA Number44D2090884
Laboratory TypePhysician Office
Certificate Effective DateFebruary 2, 2025
Certificate Expiration DateFebruary 1, 2027
Laboratory DirectorJonathan Ellichman
Laboratory Phone(901) 259-2718
Laboratory LocationSouthern Cardiovascular6401 Poplar Ave, Suite 410, 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.

Other Providers at the Same Location NPPES

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

Surgery (Vascular Surgery)
6401 POPLAR AVE STE 410
MEMPHIS, TN 38119

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 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.

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.

When was this NPI record last updated?

The NPPES record for Southern Cardiovascular PLLC was last updated on August 15, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.