| Integrated Wound Care Tennessee Pllc | |
|
141 N Mclean Blvd Memphis TN 38104-2693 | |
| (732) 451-4318 | |
| Not Available |
| Full Name | Integrated Wound Care Tennessee Pllc |
|---|---|
| Speciality | General Practice |
| Location | 141 N Mclean Blvd, Memphis, Tennessee |
| Authorized Official Name and Position | Diane Lusas (PRESIDENT) |
| Authorized Official Contact | 7324514318 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrated Wound Care Tennessee Pllc 492c Cedar Ln Ste 514 Teaneck NJ 07666-1713 Ph: () - | Integrated Wound Care Tennessee Pllc 141 N Mclean Blvd Memphis TN 38104-2693 Ph: (732) 451-4318 |
| NPI Number | 1215593991 |
|---|---|
| Provider Enumeration Date | 05/17/2019 |
| Last Update Date | 05/17/2019 |
| Medicare PECOS PAC ID | 8527394477 |
|---|---|
| Medicare Enrollment ID | O20190730002619 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215593991 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Peter B Amminger |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1932102142 PECOS PAC ID: 1557343878 Enrollment ID: I20040602000173 |
| Provider Name | Chered P Pearson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194708578 PECOS PAC ID: 6406826080 Enrollment ID: I20040729001528 |
| Provider Name | Teresa J Regan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457337966 PECOS PAC ID: 4284605031 Enrollment ID: I20040804000939 |
| Provider Name | Eleanor E Hess |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982607099 PECOS PAC ID: 0143297747 Enrollment ID: I20050516000465 |
| Provider Name | Leslie D Stewart |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1902874282 PECOS PAC ID: 6709820939 Enrollment ID: I20050617000397 |
| Provider Name | Michelle Holmes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174770713 PECOS PAC ID: 5799843421 Enrollment ID: I20081029000936 |
| Provider Name | Linda A Foster |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528055381 PECOS PAC ID: 0941391817 Enrollment ID: I20081114000175 |
| Provider Name | Frances E Hibbs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861456428 PECOS PAC ID: 9133313802 Enrollment ID: I20101027000745 |
| Provider Name | Paul Tidmore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457671380 PECOS PAC ID: 9537342183 Enrollment ID: I20110321000329 |
| Provider Name | Shannon R Atchison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902950850 PECOS PAC ID: 3971524067 Enrollment ID: I20111020000652 |
| Provider Name | Heather C Bohannon Iyama |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447654132 PECOS PAC ID: 9032432943 Enrollment ID: I20141230000720 |
| Provider Name | Johnna M Sprague |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194190306 PECOS PAC ID: 1759686819 Enrollment ID: I20160226001523 |
| Provider Name | Margaret Gilmer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891152138 PECOS PAC ID: 5597061945 Enrollment ID: I20160310000808 |
| Provider Name | Annette Caple |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013250166 PECOS PAC ID: 1951693662 Enrollment ID: I20160720000972 |
| Provider Name | Shonda L Tucker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528436334 PECOS PAC ID: 4789968819 Enrollment ID: I20170308002241 |
| Provider Name | Kristina Favaloro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306294327 PECOS PAC ID: 3678830346 Enrollment ID: I20171205002105 |
| Provider Name | Tamara Heppeard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558858290 PECOS PAC ID: 5698028744 Enrollment ID: I20181019001141 |
| Provider Name | Frank Anderson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497149884 PECOS PAC ID: 2264745835 Enrollment ID: I20190107000580 |
| Provider Name | Diane Lusas |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1730475658 PECOS PAC ID: 9032430640 Enrollment ID: I20190730002842 |
| Provider Name | Sheg Aranmolate |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528488699 PECOS PAC ID: 1153651799 Enrollment ID: I20190925001710 |
| Provider Name | Sarah Bell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336767482 PECOS PAC ID: 9032534557 Enrollment ID: I20200730003754 |
| Provider Name | Meagan Lyn Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104433192 PECOS PAC ID: 5799105375 Enrollment ID: I20201020003736 |
| Provider Name | Erin E O'sullivan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558339887 PECOS PAC ID: 8628052040 Enrollment ID: I20210623004161 |
| Provider Name | Chloe Henry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023642071 PECOS PAC ID: 9234532839 Enrollment ID: I20210720002091 |
| Provider Name | Kasey R Stamper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942891965 PECOS PAC ID: 1052718764 Enrollment ID: I20210923000483 |
| Provider Name | Bethany Rock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235641630 PECOS PAC ID: 1850796137 Enrollment ID: I20211111001905 |
| Provider Name | Lauren Elizabeth Bujenita |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1972132728 PECOS PAC ID: 5193155190 Enrollment ID: I20211122000820 |
| Provider Name | Brandy L Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477212637 PECOS PAC ID: 9739572413 Enrollment ID: I20220201001063 |
| Provider Name | Spencer Cook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750998985 PECOS PAC ID: 1850707449 Enrollment ID: I20220331002059 |
| Provider Name | Christy Hager |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073121182 PECOS PAC ID: 4688060981 Enrollment ID: I20220414000831 |
| Provider Name | Catherine Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730885328 PECOS PAC ID: 7517325384 Enrollment ID: I20230627001181 |
| Provider Name | Stephanie L Dyle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578249959 PECOS PAC ID: 8426418401 Enrollment ID: I20230721003399 |
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