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3360 N Watkins St Memphis TN 38127-6432 | |
| (901) 401-7150 | |
| (901) 347-1285 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 3360 N Watkins St, Memphis, Tennessee |
| Authorized Official Name and Position | Griffin Robert Myers (CMO) |
| Authorized Official Contact | 3072642085 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 746725 Atlanta GA 30374-6725 Ph: (312) 733-9730 | 3360 N Watkins St Memphis TN 38127-6432 Ph: (901) 401-7150 |
| NPI Number | 1720635790 |
|---|---|
| Provider Enumeration Date | 08/23/2019 |
| Last Update Date | 06/29/2023 |
| Medicare PECOS PAC ID | 7810282191 |
|---|---|
| Medicare Enrollment ID | O20200115002003 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720635790 | NPI | - | NPPES |
| 59583 | Other | TN | MEDICAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Robert Burns |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1669470316 PECOS PAC ID: 9537121009 Enrollment ID: I20041101000369 |
| Provider Name | Tamara F Davis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528066719 PECOS PAC ID: 2163467762 Enrollment ID: I20050623000925 |
| Provider Name | Karima Causey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447388186 PECOS PAC ID: 3274629282 Enrollment ID: I20071022000321 |
| Provider Name | Jana Robinson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144358722 PECOS PAC ID: 5395817084 Enrollment ID: I20080714000171 |
| Provider Name | Sonal Mehr |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205057957 PECOS PAC ID: 5991860363 Enrollment ID: I20090218000504 |
| Provider Name | Lisa Mahan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508824285 PECOS PAC ID: 9032303425 Enrollment ID: I20101029000748 |
| Provider Name | Katherine L Mullins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750589347 PECOS PAC ID: 6901090976 Enrollment ID: I20101103000949 |
| Provider Name | Octavian Sharp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184938201 PECOS PAC ID: 9931389707 Enrollment ID: I20110210000919 |
| Provider Name | Sheetal M Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528393667 PECOS PAC ID: 8123277043 Enrollment ID: I20121009000171 |
| Provider Name | Ramika L Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952630816 PECOS PAC ID: 7618104670 Enrollment ID: I20131218001535 |
| Provider Name | Susan Wall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902105117 PECOS PAC ID: 8820229719 Enrollment ID: I20140318000159 |
| Provider Name | Windy Demoura |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578971263 PECOS PAC ID: 3476775362 Enrollment ID: I20141108000151 |
| Provider Name | Deborah Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821391574 PECOS PAC ID: 5890091367 Enrollment ID: I20160309000970 |
| Provider Name | Armenthry Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073576393 PECOS PAC ID: 2062305949 Enrollment ID: I20160526001739 |
| Provider Name | Keri L Hudson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770935967 PECOS PAC ID: 0941598684 Enrollment ID: I20161012000423 |
| Provider Name | Timberlyn M Beal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932551850 PECOS PAC ID: 1153602040 Enrollment ID: I20170109001860 |
| Provider Name | Cheryl D Givens |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871746800 PECOS PAC ID: 1850558768 Enrollment ID: I20181012002124 |
| Provider Name | Anna Poulos |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689121121 PECOS PAC ID: 9436438876 Enrollment ID: I20200115002112 |
| Provider Name | Arqutia Hill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386294759 PECOS PAC ID: 7719313063 Enrollment ID: I20200204001614 |
| Provider Name | Ali Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710202999 PECOS PAC ID: 7810137718 Enrollment ID: I20200826001717 |
| Provider Name | Justin Hunt |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326138074 PECOS PAC ID: 6901842228 Enrollment ID: I20210121001810 |
| Provider Name | Mira Desai |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538559190 PECOS PAC ID: 6800104787 Enrollment ID: I20210127003198 |
| Provider Name | Vivian Gaines-thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790197283 PECOS PAC ID: 9335364538 Enrollment ID: I20220329000580 |
| Provider Name | James Joseph Ryan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346735685 PECOS PAC ID: 7517343254 Enrollment ID: I20221003002090 |
| Provider Name | Rachel Sabb |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629321096 PECOS PAC ID: 0547412371 Enrollment ID: I20221117001206 |
| Provider Name | Timanika Dansby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083016547 PECOS PAC ID: 5698061299 Enrollment ID: I20230303000436 |
| Provider Name | Rachel Hildebrand |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528531258 PECOS PAC ID: 7416299748 Enrollment ID: I20230306000147 |
| Provider Name | Tuwanda Williamson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629018528 PECOS PAC ID: 6608817630 Enrollment ID: I20230505001576 |
| Provider Name | Ricki Briana Martin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922717065 PECOS PAC ID: 6608237573 Enrollment ID: I20230726000046 |
| Provider Name | Cecelia Hooks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578633780 PECOS PAC ID: 1355753930 Enrollment ID: I20230927004161 |
| Provider Name | Rebecca Murray |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134557473 PECOS PAC ID: 2365675451 Enrollment ID: I20240208001130 |
| Provider Name | Dominique Nicole Vaughn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124884895 PECOS PAC ID: 5991141939 Enrollment ID: I20240312003263 |
| Provider Name | Valorie Parham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851622468 PECOS PAC ID: 9436275872 Enrollment ID: I20240530000162 |
| Provider Name | Tracey Thomas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518901602 PECOS PAC ID: 8123026838 Enrollment ID: I20240919000251 |
| Provider Name | Jennifer Noonan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386645331 PECOS PAC ID: 8123087434 Enrollment ID: I20241010003104 |
| Provider Name | Quanza Mooring |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770281016 PECOS PAC ID: 8224402920 Enrollment ID: I20241114000547 |
| Provider Name | Shannon Krop |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104393347 PECOS PAC ID: 4082956172 Enrollment ID: I20241122004060 |
Christ Commuity Health Services Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3360 S 3rd St, Memphis, TN 38109 Phone: 901-842-3160 Fax: 901-842-2360 | |
Elite Patient Care Of Tennessee Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 100 Peabody Pl Ste 150, Memphis, TN 38103 Phone: 337-408-0797 | |
Preventivemd, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1407 Union Ave Ste 305, Memphis, TN 38104 Phone: 901-609-2444 | |
Jerry M Holley Md Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4100 Austin Peay Hwy, Memphis, TN 38128 Phone: 901-486-1151 Fax: 901-844-1439 | |
Spirit Health Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1331 Union Ave Ste 1240, Memphis, TN 38104 Phone: 901-832-6734 | |
Embrace Community Development Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1419 Breedlove St, Memphis, TN 38107 Phone: 901-484-3357 | |
Peabody Family Care, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1325 Eastmoreland Avenue, Suite 150, Memphis, TN 38104 Phone: 901-725-0648 Fax: 901-725-1037 |