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  7. NPI Record 1346334448

MR. MARDRAKUS T MERRIWEATHER MED
Complete NPI Record 1346334448
Counselor in Memphis, TN

NPI Status: Active since October 03, 2006

Contact Information

3810 WINCHESTER RD
SOUTHEAST MENTAL HEALTH CENTER
MEMPHIS, TN
ZIP 38118
Phone: (901) 369-1420
Fax: (901) 369-1433

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Provider Last Name Legal Name
  4. Provider First Name
  5. Provider Middle Name
  6. Provider Name Prefix Text
  7. Provider Credential Text
  8. Provider First Line Business Mailing Address
  9. Provider Second Line Business Mailing Address
  10. Provider Business Mailing Address City Name
  11. Provider Business Mailing Address State Name
  12. Provider Business Mailing Address Postal Code
  13. Provider Business Mailing Address Country Code If outside U S
  14. Provider Business Mailing Address Telephone Number
  15. Provider Business Mailing Address Fax Number
  16. Provider First Line Business Practice Location Address
  17. Provider Second Line Business Practice Location Address
  18. Provider Business Practice Location Address City Name
  19. Provider Business Practice Location Address State Name
  20. Provider Business Practice Location Address Postal Code
  21. Provider Business Practice Location Address Country Code If outside U S
  22. Provider Business Practice Location Address Telephone Number
  23. Provider Business Practice Location Address Fax Number
  24. Provider Enumeration Date
  25. Last Update Date
  26. Provider Gender Code
  27. Healthcare Provider Taxonomy Code 1
  28. Healthcare Provider Primary Taxonomy Switch 1
  29. Healthcare Provider Taxonomy Code 2
  30. Healthcare Provider Primary Taxonomy Switch 2
  31. Is Sole Proprietor

Complete NPI Dataset

This page represents the complete record for NPI 1346334448. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1346334448
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 1
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
The last name of the provider. If the provider is an individual, this is the legal name.
Provider First Name: MARDRAKUS
The first name of the provider, if the provider is an individual.
Provider Middle Name: T
The middle name of the provider, if the provider is an individual.
Provider Name Prefix Text: MR.
The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
Provider Credential Text: MED
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Provider First Line Business Mailing Address: 3810 WINCHESTER
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Second Line Business Mailing Address: SOUTHEAST MHC
The second line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider second line location address’’.
Provider Business Mailing Address City Name: MEMPHIS
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: TN
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code: 381189007
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number: 9013691400
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Mailing Address Fax Number: 9013691433
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider First Line Business Practice Location Address: 3810 WINCHESTER RD
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Second Line Business Practice Location Address: SOUTHEAST MENTAL HEALTH CENTER
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: MEMPHIS
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: TN
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 381189007
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 9013691420
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 9013691433
The fax number associated with the location address of the provider being identified.
Provider Enumeration Date: 10/3/2006
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 7/8/2007
The date that a record was last updated or changed.
Provider Gender Code: M
The code designating the provider’s gender if the provider is a person.
Healthcare Provider Taxonomy Code 1: 101Y00000X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1: X
Healthcare Provider Taxonomy Code 2: 101YM0800X
Healthcare Provider Primary Taxonomy Switch 2: X
Is Sole Proprietor: N
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No