| Blues City Psychiatry, Pllc | |
|
8336 Macon Rd Cordova TN 38018-8554 | |
| (901) 682-3035 | |
| (901) 628-3049 |
| Full Name | Blues City Psychiatry, Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 8336 Macon Rd, Cordova, Tennessee |
| Authorized Official Name and Position | Shubi R Mukatira (OWNER) |
| Authorized Official Contact | 9017371992 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blues City Psychiatry, Pllc 1138 N Germantown Pkwy Suite 101-110 Cordova TN 38016-5872 Ph: (901) 737-1992 | Blues City Psychiatry, Pllc 8336 Macon Rd Cordova TN 38018-8554 Ph: (901) 682-3035 |
| NPI Number | 1750696340 |
|---|---|
| Provider Enumeration Date | 08/09/2010 |
| Last Update Date | 08/20/2024 |
| Certification Date | 08/20/2024 |
| Medicare PECOS PAC ID | 7618001470 |
|---|---|
| Medicare Enrollment ID | O20100816000249 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750696340 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 42712 (Tennessee) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| Provider Name | Carl Maclin Da Cunha |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629087945 PECOS PAC ID: 9436247145 Enrollment ID: I20071114000077 |
| Provider Name | Shubi R Mukatira |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497966469 PECOS PAC ID: 2365575560 Enrollment ID: I20100809000126 |
| Provider Name | Allyson B Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407115579 PECOS PAC ID: 0143485219 Enrollment ID: I20120625000067 |
| Provider Name | Uthappa S Mukatira |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336519925 PECOS PAC ID: 0345541553 Enrollment ID: I20151214000097 |
| Provider Name | Jennifer Scott Carmichael |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952991788 PECOS PAC ID: 7517366107 Enrollment ID: I20210602001602 |
| Provider Name | Toya Evette Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699496166 PECOS PAC ID: 9931554102 Enrollment ID: I20231006003096 |
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