| Vitae Health Medical Tennessee Pllc | |
|
141 N Mclean Blvd Memphis TN 38104-2693 | |
| (224) 777-8034 | |
| Not Available |
| Full Name | Vitae Health Medical Tennessee Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 141 N Mclean Blvd, Memphis, Tennessee |
| Authorized Official Name and Position | Amish M Patel (PRESIDENT) |
| Authorized Official Contact | 2247778034 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vitae Health Medical Tennessee Pllc 3450 Oakton St Ste 300 Skokie IL 60076-2951 Ph: (224) 777-8034 | Vitae Health Medical Tennessee Pllc 141 N Mclean Blvd Memphis TN 38104-2693 Ph: (224) 777-8034 |
| NPI Number | 1124659321 |
|---|---|
| Provider Enumeration Date | 01/28/2020 |
| Last Update Date | 09/30/2021 |
| Medicare PECOS PAC ID | 4587085469 |
|---|---|
| Medicare Enrollment ID | O20200601002500 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124659321 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Angela D Watson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275601346 PECOS PAC ID: 5092603050 Enrollment ID: I20040310000399 |
| Provider Name | Brian Billings |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194996264 PECOS PAC ID: 2466514518 Enrollment ID: I20081223000644 |
| Provider Name | Crystal Chambliss |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316471543 PECOS PAC ID: 9234406075 Enrollment ID: I20170525001846 |
| Provider Name | Lekeisha Anderson Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427441419 PECOS PAC ID: 4284949827 Enrollment ID: I20180814003747 |
| Provider Name | Leon K Edwards |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982828158 PECOS PAC ID: 9638501950 Enrollment ID: I20191107000349 |
| Provider Name | Amish M Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457502619 PECOS PAC ID: 4082801964 Enrollment ID: I20200601002879 |
| Provider Name | Donna Luckett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609332840 PECOS PAC ID: 8729400395 Enrollment ID: I20200629000468 |
| Provider Name | Tammy Dunson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992319487 PECOS PAC ID: 7416363585 Enrollment ID: I20210316000647 |
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