| 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 | 1770182735 |
|---|---|
| Provider Enumeration Date | 10/21/2020 |
| Last Update Date | 11/17/2022 |
| Medicare PECOS PAC ID | 4880004183 |
|---|---|
| Medicare Enrollment ID | O20210506000891 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770182735 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 207RN0300X | Internal Medicine - Nephrology | (* (Not Available)) | Primary |
| Provider Name | Carrie R Hyde |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1114260726 PECOS PAC ID: 1658696307 Enrollment ID: I20170615000410 |
| Provider Name | Elizabeth Gager |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144512294 PECOS PAC ID: 6800073925 Enrollment ID: I20210506001124 |
| Provider Name | Shaminder Gupta |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1730183401 PECOS PAC ID: 1658322300 Enrollment ID: I20210506001442 |
| Provider Name | Ashley Croom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295396661 PECOS PAC ID: 5496183170 Enrollment ID: I20210902000648 |
| Provider Name | Noel Meikle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053887554 PECOS PAC ID: 7315278611 Enrollment ID: I20220927001193 |
| Provider Name | Roshan D Rajani |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1336494145 PECOS PAC ID: 2567785694 Enrollment ID: I20230531002556 |
| Provider Name | Rashmi Bisla |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1265758635 PECOS PAC ID: 0143531871 Enrollment ID: I20240613004452 |
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