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MODERN GYNECOLOGY AND REPRODUCTIVE HEALTH PC
NPI 1962056036
Obstetrics & Gynecology - Gynecology in Memphis, TN

Active since July 27, 2019
1407 UNION AVE STE 1401, MEMPHIS, TN 38104(901) 701-1777(901) 701-1778 Get Directions Write a Review

NPPES record last updated: November 1, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 1, 2019, Sep 13, 2019, Jul 27, 2019 (3 updates tracked since 2019).

About Modern Gynecology And Reproductive Health Pc NPPES

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

MODERN GYNECOLOGY AND REPRODUCTIVE HEALTH PC (NPI 1962056036) is a healthcare organization registered as a gynecology in Memphis, Tennessee and active in the NPI registry since July 2019. The organization lists Susan Northen Lacy, Physician Owner, as its authorized official.

NPPES Registry Identity

NPI1962056036
Entity TypeOrganization
Primary Taxonomy207VG0400X
Legal Business NameMODERN GYNECOLOGY AND REPRODUCTIVE HEALTH PC
Location Address1407 UNION AVE STE 1401Memphis, TN 38104-3667
Mailing Address1407 Union Ave Ste 1401Memphis, TN 38104-3667 · (901) 483-0619
Phone(901) 701-1777
Fax(901) 701-1778
Organization SubpartNo
Authorized OfficialSusan Northen LacyPhysician Owner · (901) 289-0915
Enumeration DateJuly 27, 2019
Last NPPES UpdateNovember 1, 20193 updates tracked since enumeration
✔ NPI 1962056036 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & Gynecology · GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207VG0400X
Definition
A physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions. Source: National Uniform Claim Committee
1407 UNION AVE STE 1401, Memphis, TN 38104
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Other Identifiers 1

MedicaidQ053117TN

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

Other Providers at the Same Location NPPES

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

MORE 901 LLC
Obstetrics & Gynecology (Gynecology)
1407 UNION AVE STE 1401
MEMPHIS, TN 38104
Shelby County (901) 701-1777

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 Modern Gynecology And Reproductive Health PC's NPI number?

The NPI number for Modern Gynecology And Reproductive Health PC is 1962056036. It was assigned to this organization in the NPPES registry on July 27, 2019.

Where is Modern Gynecology And Reproductive Health PC located?

Modern Gynecology And Reproductive Health PC is located at 1407 Union Ave Ste 1401, Memphis, TN 38104. The listed phone number is (901) 701-1777.

What is Modern Gynecology And Reproductive Health PC's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology, specializing in Gynecology, with taxonomy code 207VG0400X.

When was this NPI record last updated?

The NPPES record for Modern Gynecology And Reproductive Health PC was last updated on November 1, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.