# GASTROENTEROLOGY CENTER OF THE MIDSOUTH PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Midstate Gastroenterology, Associates In Gastroenterology, Gastroenterology Associates of North Mississippi, Digestive Health Specialists, Gastro One, Skyline Gastroenterology of West Tennessee
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417932492
- **Authorized official:** KRISTINA MATERNA (DIRECTOR, CREDENTIALING)
- **Authorized official phone:** (901) 377-8219

## Contact information

- **Practice address:** 8000 WOLF RIVER BLVD STE 200, GERMANTOWN, TN 38138-1755
- **Practice address phone:** (901) 747-3630
- **Mailing address:** ONE GI CREDENTIALING DEPARTMENT, PO BOX 381468, GERMANTOWN, TN 38183-1468

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RG0100X | Gastroenterology Physician | — | NULL | Yes |
| 207RG0100X | Gastroenterology Physician | — | — | Yes |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | NULL | — |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |
| 367500000X | Certified Registered Nurse Anesthetist | — | NULL | — |
| 367500000X | Certified Registered Nurse Anesthetist | — | — | — |

## Other

- **Enumeration date:** 12/13/2005
- **Last updated:** 02/03/2026