| Wellmind, Llc | |
|
8304 Walnut Grove Rd Cordova TN 38018-6869 | |
| (901) 501-7700 | |
| Not Available |
| Full Name | Wellmind, Llc |
|---|---|
| Speciality | Counselor |
| Location | 8304 Walnut Grove Rd, Cordova, Tennessee |
| Authorized Official Name and Position | John Redmond (LEAD NURSE PRACTITIONER) |
| Authorized Official Contact | 9018700258 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellmind, Llc 8304 Walnut Grove Rd Cordova TN 38018-6869 Ph: (901) 501-7700 | Wellmind, Llc 8304 Walnut Grove Rd Cordova TN 38018-6869 Ph: (901) 501-7700 |
| NPI Number | 1760105431 |
|---|---|
| Provider Enumeration Date | 09/19/2022 |
| Last Update Date | 09/19/2022 |
| Certification Date | 09/19/2022 |
| Medicare PECOS PAC ID | 6406229285 |
|---|---|
| Medicare Enrollment ID | O20230224002269 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760105431 | NPI | - | NPPES |
| Provider Name | John C Bomar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922029586 PECOS PAC ID: 4880651603 Enrollment ID: I20041214000305 |
| Provider Name | Collietta C Bassett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063976983 PECOS PAC ID: 7315277084 Enrollment ID: I20210823001699 |
| Provider Name | Tommerria Ross |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639715253 PECOS PAC ID: 4082035589 Enrollment ID: I20220914001922 |
| Provider Name | Lekisha Caprice Pride |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154106508 PECOS PAC ID: 4486005295 Enrollment ID: I20240304003372 |
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