| Monogram Health Professional Services Pc | |
|
5410 Maryland Way Ste 301 Brentwood TN 37027-5064 | |
| (615) 673-4455 | |
| Not Available |
| Full Name | Monogram Health Professional Services Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 5410 Maryland Way Ste 301, Brentwood, Tennessee |
| Authorized Official Name and Position | Shawn Verner (GENERAL COUNSEL AND SECRETARY) |
| Authorized Official Contact | 6159941889 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Monogram Health Professional Services Pc 5410 Maryland Way Ste 301 Brentwood TN 37027-5064 Ph: (615) 673-4455 | Monogram Health Professional Services Pc 5410 Maryland Way Ste 301 Brentwood TN 37027-5064 Ph: (615) 673-4455 |
| NPI Number | 1255930228 |
|---|---|
| Provider Enumeration Date | 10/21/2020 |
| Last Update Date | 11/17/2022 |
| Medicare PECOS PAC ID | 4880004183 |
|---|---|
| Medicare Enrollment ID | O20210505003249 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255930228 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 207RN0300X | Internal Medicine - Nephrology | (* (Not Available)) | Primary |
| Provider Name | Tracy E Shah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205025749 PECOS PAC ID: 5294813887 Enrollment ID: I20080423000004 |
| Provider Name | Demetrious Blackmon |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1578592994 PECOS PAC ID: 6103851225 Enrollment ID: I20080520000248 |
| Provider Name | Gema Lindsay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093257933 PECOS PAC ID: 6507149127 Enrollment ID: I20170206001869 |
| Provider Name | Lisa Ann Mitchell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275000721 PECOS PAC ID: 6800140120 Enrollment ID: I20181126001094 |
| Provider Name | Felice Ike |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437625860 PECOS PAC ID: 1850624941 Enrollment ID: I20190604002868 |
| Provider Name | Denise Pennicooke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962962530 PECOS PAC ID: 0840622122 Enrollment ID: I20191107003298 |
| Provider Name | Magdalene Oziwo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245688613 PECOS PAC ID: 3779919931 Enrollment ID: I20200206000865 |
| Provider Name | Allyson Blue |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184288730 PECOS PAC ID: 3375961220 Enrollment ID: I20200909003499 |
| Provider Name | Shaminder Gupta |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1730183401 PECOS PAC ID: 1658322300 Enrollment ID: I20210505003250 |
| Provider Name | Ashley Croom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295396661 PECOS PAC ID: 5496183170 Enrollment ID: I20210824003527 |
| Provider Name | Kristy Bearden Linder |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1073048807 PECOS PAC ID: 0446639611 Enrollment ID: I20220617000858 |
| Provider Name | Noel Meikle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053887554 PECOS PAC ID: 7315278611 Enrollment ID: I20220722001701 |
| Provider Name | Wyshika Gibson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245828029 PECOS PAC ID: 0143619775 Enrollment ID: I20220722001857 |
| Provider Name | Leslie Carnahan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801092424 PECOS PAC ID: 0244464980 Enrollment ID: I20220726000006 |
| Provider Name | Vanessa Hixon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316675549 PECOS PAC ID: 1557745841 Enrollment ID: I20220906002214 |
| Provider Name | Sharmila Devidoss |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1124169396 PECOS PAC ID: 1557684503 Enrollment ID: I20221110002239 |
| Provider Name | Christopher Pile |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1447367057 PECOS PAC ID: 4981671104 Enrollment ID: I20221206000745 |
| Provider Name | Ricardo Rodriguez-santos |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1275932204 PECOS PAC ID: 3274801600 Enrollment ID: I20221216002305 |
| Provider Name | Susan Bell |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1336285873 PECOS PAC ID: 7517122013 Enrollment ID: I20230104002009 |
| Provider Name | Lubna Aslam Rashid |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1760626337 PECOS PAC ID: 9739374851 Enrollment ID: I20230118001261 |
| Provider Name | Zahily Fals |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1598078115 PECOS PAC ID: 6103121520 Enrollment ID: I20230728002406 |
| Provider Name | Nyeshia Sherelle Cohill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194355859 PECOS PAC ID: 6103289210 Enrollment ID: I20230822003849 |
| Provider Name | Cheryl Clayton |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1114979184 PECOS PAC ID: 5799720801 Enrollment ID: I20230823001038 |
| Provider Name | Robin Stone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598912206 PECOS PAC ID: 1951696830 Enrollment ID: I20230912003635 |
| Provider Name | Moniba Bilal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659502441 PECOS PAC ID: 7517115074 Enrollment ID: I20230920002714 |
| Provider Name | Carrie R Hyde |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1114260726 PECOS PAC ID: 1658696307 Enrollment ID: I20231011002295 |
| Provider Name | Lisa D Cox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699401935 PECOS PAC ID: 1951784081 Enrollment ID: I20231122002156 |
| Provider Name | Amanda Bahler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245785013 PECOS PAC ID: 2860776481 Enrollment ID: I20231127002226 |
| Provider Name | Rick Michel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396079562 PECOS PAC ID: 3375938673 Enrollment ID: I20231128001255 |
| Provider Name | Chelsea Dawn Malinowski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659899375 PECOS PAC ID: 4587921895 Enrollment ID: I20231209000647 |
| Provider Name | Paul Naenge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972018364 PECOS PAC ID: 4486032687 Enrollment ID: I20231215001239 |
| Provider Name | Pamela Lane |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780106328 PECOS PAC ID: 2365717709 Enrollment ID: I20240208002064 |
| Provider Name | Luis Santiago |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699423012 PECOS PAC ID: 6709264989 Enrollment ID: I20240215000687 |
| Provider Name | Melissa Roman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881070688 PECOS PAC ID: 2769799139 Enrollment ID: I20240327002293 |
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