DR. YONIQUE PETRECE PETGRAVE (NPI# 1235545849) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235545849 |
| Entity Type | Individual |
| Full Name | DR. YONIQUE PETRECE PETGRAVE |
| Credential | M.D. |
| Practice Address |
51 N Dunlap St Ste 400 Memphis TN 38105-4625 |
| Mailing Address |
850 Poplar Ave Bldg 2 Memphis TN 38105-4607 |
| Practice Telephone | 9012877337 |
| Mailing Telephone | 9012878693 |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2020-07-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0210X |
Pediatrics Specialization: Pediatric Nephrology |
60407 | TN | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | 19723 | FL | Student, Health Care |
| Street Address |
51 N DUNLAP ST STE 400 |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38105-4625 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750380051 | Ashley B Escue | Specialist | 51 N Dunlap St Ste 400, Memphis, TN 38105-4625 | 2005-07-19 |
| 1427599034 | Holly Lydigsen | Nurse Practitioner | 51 N Dunlap St Ste 400, Memphis, TN 38105-4625 | 2017-03-15 |
| 1053737536 | Bruce Raymond Haas | Genetic Counselor, MS | 51 N Dunlap St Ste 400, Memphis, TN 38105-4625 | 2014-03-08 |
| 1992146955 | Nour Akil | Pediatrics | 51 N Dunlap St Ste 400, Memphis, TN 38105 | 2013-07-08 |
| 1205179934 | Catherine Hammond | Pediatrics | 51 N Dunlap St Ste 400, Memphis, TN 38105-4625 | 2013-04-01 |
| 1780933531 | Divya Salhan | Pediatrics | 51 N Dunlap St Ste 400, Memphis, TN 38105 | 2012-09-06 |
| 1972859890 | Ahsan Bashir | Pediatrics | 51 N Dunlap St Ste 400, Memphis, TN 38105-4625 | 2012-07-29 |
| 1366727893 | Anushree M Algotar | Pediatrics | 51 N Dunlap St Ste 400, Memphis, TN 38105-4625 | 2011-10-16 |
| 1932492816 | Stacey Lee Morgan | Nurse Practitioner | 51 N Dunlap St Ste 400, Memphis, TN 38105-4625 | 2011-05-25 |
| 1467774844 | Maria Alejandra Carrillo-marquez | Pediatrics | 51 N Dunlap St Ste 400, Memphis, TN 38105-4625 | 2010-02-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447887435 | Leeanne Chittom Mcdonald | Dietitian, Registered | Ulps Surgery, 2nd Floor, 50 N. Dunlap, Memphis, TN 38105 | 2020-03-27 |
| 1619508942 | Victoria Mackay | Physician Assistant | 595 Danny Thomas Place, Memphis, TN 38105 | 2020-01-27 |
| 1720436710 | Angela Marie Pratt | Nurse Practitioner | 262 Danny Thomas Blvd, Memphis, TN 38105 | 2016-05-31 |
| 1326434465 | Amanda Green | Pediatrics | 262 N Danny Thomas Blvd # Ms 320, Memphis, TN 38105 | 2015-04-15 |
| 1467864173 | Nicole Mary Alberts | Psychologist | 262 Danny Thomas Place, Mail Stop 740, Department of Psychology, St Jude Children's Research H, Memphis, TN 38105 | 2014-05-29 |
| 1689004160 | Virginia Carney | Dietitian, Registered | 262 Danny Thomas Place - Mail Stop 732, Memphis, TN 38105 | 2013-11-19 |
| 1447506365 | Nickhill Hitesh Bhakta | Pediatrics | 262 Danny Thomas Way, Ms 721, Memphis, TN 38105 | 2012-07-29 |
| 1457622235 | Healthy Indigent Populations Inc. | Exclusive Provider Organization | 1066 Delmar, Memphis, TN 38105 | 2012-01-25 |
| 1285953265 | Nicholas Steve Phillips | Student in an Organized Health Care Education/Training Program | 262 Danny Thomas Place, Mail Stop 735, Memphis, TN 38105 | 2010-05-31 |
| 1205151776 | Kyle Joseph Morgan | Anesthesiology | 262 Danny Thomas Pl Dept Of, Memphis, TN 38105 | 2010-03-28 |
| Find all providers in zip 38105 | ||||
| Taxonomy Code | 2080P0210X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Nephrology |
| A pediatrician who deals with the normal and abnormal development and maturation of the kidney and urinary tract, the mechanisms by which the kidney can be damaged, the evaluation and treatment of renal diseases, fluid and electrolyte abnormalities, hypertension and renal replacement therapy. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265500888 | John J Bissler | Pediatrics | 51 N Dunlap St., Ste. 400, Memphis, TN 38105 | 2006-12-01 |
| 1386925634 | Arwa Nada | Pediatrics | 51 N Dunlap St, Ste. 400, Memphis, TN 38105 | 2011-08-31 |
| 1841503059 | Rima S. Zahr | Pediatrics | 51 N Dunlap St, Ste. L400, Memphis, TN 38105-4625 | 2010-07-16 |
| 1679746119 | James Gilbert Atherton | Pediatrics | 51 N Dunlap St, Ste. 400, Memphis, TN 38105 | 2008-04-04 |
| 1912965070 | Robert J Wyatt | Pediatrics | 1910 Nonconnah Blvd, Suite 120, Memphis, TN 38132-2113 | 2006-05-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942384060 | Valentina Kon | Pediatrics | 3601 Tvc, Nashville, TN 37232-0001 | 2006-10-25 |
| 1902993009 | Kathy Jabs | Pediatrics | 3601 Tvc, Nashville, TN 37232-0001 | 2006-10-09 |
| 1508958919 | Tracy E Hunley | Pediatrics | 3601 Tvc, Nashville, TN 37232-0001 | 2006-09-30 |
| 1902838592 | Rene G Vandevoorde IIi | Pediatrics | 3601 The Vanderbilt Clinic, Nashville, TN 37232-5100 | 2006-07-06 |
| 1659308187 | Billy S Arant Jr. | Pediatrics | 979 East Third Street, Suite B-601, Chattanooga, TN 37403-3316 | 2006-06-28 |
| 1003874165 | Deborah P Jones | Pediatrics | 3601 Tvc, Nashville, TN 37232-0001 | 2006-05-01 |
| 1245297795 | Maricarmen Malagon-rogers | Pediatrics | 1924 Alcoa Hwy, U-115, Knoxville, TN 37920-1511 | 2006-04-27 |
| 1205892353 | Bettina Ault | Pediatrics | 900 E 3rd St, Chattanooga, TN 37403-2101 | 2006-04-25 |
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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.