MRS. BERENESE CANADY (NPI# 1053616292) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053616292 |
| Entity Type | Individual |
| Full Name | MRS. BERENESE CANADY |
| Credential | PMHNP, APN-BC |
| Practice Address |
4646 Poplar Ave Ste 541 Memphis TN 38117-4446 |
| Mailing Address |
3354 Faxon Ave Memphis TN 38122-3146 |
| Practice Telephone | 9012899665 |
| Mailing Telephone | 9012897031 |
| Mailing Fax Number | 9018884120 |
| Enumeration Date | 2011-01-19 |
| Last Update Date | 2020-10-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 154316 | TN | Nursing Service Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
APN16843 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
AP7769 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
2012002552 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 040115 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1111 S Stapley Dr, Mesa, AZ 852045059 | 6026856000 | 4808345703 |
| Street Address |
4646 POPLAR AVE STE 541 |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38117-4446 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154980639 | Zup Medical Services, LLC | Clinic/Center | 4576 Poplar Avenue, Memphis, TN 38117 | 2019-06-10 |
| 1104386028 | Faith Christie Leigh Roby | Counselor | 4646 Poplar Ave Ste 510, Memphis, TN 38117 | 2019-03-25 |
| 1023511300 | Genita Lashonda Johnson-hammond | Specialist | 4565 Quince Rd, 1b, Memphis, TN 38117 | 2018-03-14 |
| 1023547494 | Rivka R Braverman | Licensed Practical Nurse | 5050 Sanderlin Avenue, Memphis, TN 38117 | 2017-06-08 |
| 1285002451 | Shauna Lomax | Physical Therapy Assistant | 258 Leonora Dr, Memphis, TN 38117 | 2015-09-04 |
| 1255735569 | Caring Hearts of The Mid South | In Home Supportive Care | 4646 Poplar, Suite 213b, Memphis, TN 38117 | 2014-10-15 |
| 1063821296 | Tomasz A Charowski | Dentist | 670 Colonial Rd Ste 3, Memphis, TN 38117 | 2014-08-13 |
| 1255760385 | Tennessee Dental Professionals PC | Dentist | 370 Colonial Road, 3, Memphis, TN 38117 | 2013-11-08 |
| 1447692264 | Dory Sellers | Dentist | 4515 Poplar Avenue, Suite 406, Memphis, TN 38117 | 2013-07-22 |
| 1366791808 | Amirio Jonte Armour | Pharmacist | 1760 Moriah Woods, Suite 2, Memphis, TN 38117 | 2012-08-30 |
| Find all providers in zip 38117 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265049977 | Toya Owens | Nurse Practitioner | 2565 Mackinnon Dr, Memphis, TN 38119-7903 | 2020-09-26 |
| 1679197974 | Billi-jo Fulton | Nurse Practitioner | 6932 Guyder Rd, Memphis, NY 13112-8711 | 2020-06-02 |
| 1417518077 | Raghib Dennis | Nurse Practitioner | 1518 Arbor View Ct Apt 206, Memphis, TN 38134-8859 | 2019-06-25 |
| 1750732582 | Amanda Leigh Eaves | Nurse Practitioner | 364 S Front St Ste 201, Memphis, TN 38103 | 2016-06-22 |
| 1407115579 | Allyson Brooke Williams | Nurse Practitioner | 5050 Poplar Avenue Suite 511, Memphis, TN 38157-0618 | 2012-05-10 |
| 1497883607 | Gerome Alonzo Grivas | Nurse Practitioner | 3175 Lenox Park Blvd Ste 412, Memphis, TN 38115-4256 | 2007-03-01 |
| 1831172444 | Len N. Getz | Nurse Practitioner | 708 S Mendenhall Rd, Memphis, TN 38117-5213 | 2005-11-29 |
| 1326046707 | Angela C Hammond | Nurse Practitioner | 2579 Douglass Ave, Southeast Mental Health Center, Memphis, TN 38114-2532 | 2005-07-11 |
| 1447859053 | Willie Faye Kelly | Nurse Practitioner | 951 Court Ave, Memphis, TN 38103-2813 | 2020-10-23 |
| 1225643018 | Melanie Warren | Nurse Practitioner | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2020-09-09 |
| Find all providers in MEMPHIS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.