SOUTH MD PC
NPI 1609129139
Internal Medicine in Bartlett, TN
About South Md Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUTH MD PC (NPI 1609129139) is a healthcare organization registered as an internal medicine in Bartlett, Tennessee and active in the NPI registry since October 2012. The organization maintains a secondary practice location in Memphis and lists Oluwatoyin Jimmy Agbaosi, Provider/owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Other Identifiers 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
South Md Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to South MD PC, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 South MD PC's NPI number?
The NPI number for South MD PC is 1609129139. It was assigned to this organization in the NPPES registry on October 22, 2012.
Where is South MD PC located?
South MD PC is located at 2986 Kate Bond Rd, Bartlett, TN 38133. The listed phone number is (901) 820-7000.
What is South MD PC's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is South MD PC enrolled in Medicare?
Yes. South MD PC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through South MD PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to South MD PC, in Hospitalist and Internal Medicine. 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 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for South MD PC was last updated on June 30, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# South Md Pc · NPI 1609129139
Internal Medicine organization in Bartlett, Tennessee. Organization record, active in the CMS NPPES registry since October 22, 2012.
## Identity
- **NPI:** 1609129139 (Entity type: Organization)
- **Enumerated:** October 22, 2012
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **Organization subpart:** No
- **Authorized official:** Oluwatoyin Agbaosi, PROVIDER/OWNER
## Practice location
- **Address:** 2986 KATE BOND RD, Bartlett, TN 38133-4003
- **Phone:** (901) 820-7000
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Hospitalist (1), Internal Medicine (1); 1 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 30, 2026
- **Other identifiers:** Medicaid 1530261 (TN)
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Source: [NPI Profile](https://npiprofile.com/npi/1609129139) · Data from the CMS NPPES public registry.