PPH MEDICAL OF TN, INC DBA (NPI# 1366797276) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366797276 |
| Entity Type | Organization |
| Organization Name | PPH MEDICAL OF TN, INC DBA |
| Other Organization Name | PASSPORT HEALTH |
| Practice Address |
4515 Poplar Ave Ste 507 Memphis TN 38117-7503 |
| Mailing Address |
4515 Poplar Ave Suite 131 Memphis TN 38117 |
| Practice Telephone | 9016812700 |
| Mailing Telephone | 9016812700 |
| Mailing Fax Number | 9016812702 |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2015-07-23 |
| Authorized Official Name | MRS. TONYA PARSON (CEO) |
| Authorized Official Telephone | 9016812700 |
| Authorized Official Credential | NP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers |
| Other Name | Type Code |
|---|---|
| Passport Health | Doing Business As Name - Organization |
| Street Address |
4515 POPLAR AVE STE 507 |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38117-7503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548230691 | John W Mccoy | Psychologist | 4515 Poplar Ave, Memphis, TN 38117-7503 | 2006-01-23 |
| 1821435884 | Msk Group, PC | Orthopaedic Surgery | 4515 Poplar Ave, Suite 206, Memphis, TN 38117 | 2013-05-31 |
| 1851693857 | Carmen Taylor | Marriage & Family Therapist | 4515 Poplar Ave, Memphis, TN 38117 | 2010-11-23 |
| 1619126604 | Sheila C Vamplin | Marriage & Family Therapist | 4515 Poplar Ave, Suite 422, Memphis, TN 38117-7503 | 2008-09-15 |
| 1073770178 | William E Lloyd | Dentist | 4515 Poplar Ave, #225, Memphis, TN 38117-7503 | 2008-05-18 |
| 1093900474 | Mihaela Leordeanu | Dentist | 4515 Poplar Ave, Ste. 227, Memphis, TN 38117-7503 | 2007-09-10 |
| 1477762664 | Mary R Dean | Counselor | 4515 Poplar Ave, Suite 515, Memphis, TN 38117 | 2007-05-22 |
| 1972662443 | Carol E. Sams | Counselor | 4515 Poplar Ave, Suite 411, Memphis, TN 38117-7503 | 2006-12-08 |
| 1528133352 | Charles Zel Plesofsky | Dentist | 4515 Poplar Ave, Suite 300, Memphis, TN 38117-7503 | 2006-11-21 |
| 1477651545 | Wallace Wymon Dyke | Dentist | 4515 Poplar Ave, Ste. 406, Memphis, TN 38117-7503 | 2006-09-20 |
| Find all providers in the same location | ||||
| 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 | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982204038 | Ann Clare Guest | Nurse Practitioner | 1483 Goodbar Ave, Memphis, TN 38104-4912 | 2020-10-28 |
| 1154936946 | Allyson Escott Dormois | Nurse Practitioner | 130 Flicker St, Memphis, TN 38104-5928 | 2020-09-09 |
| 1831702224 | Tennessee In-home Partner-iv, LLC | Nurse Practitioner | Sumner Medical Plaza, 300 Steam Plant Road, Suite 220, Memphis, TN 37066-3032 | 2020-08-26 |
| 1881160059 | Christopher Paul Hernandez | Nurse Practitioner | 877 Jeffeon Ave, Memphis, TN 38103 | 2018-10-15 |
| 1326544800 | Kimberly Vestoria Mcclinton | Nurse Practitioner | 2200 Union Ave 1, Memphis, TN 38104 | 2018-04-03 |
| 1780199786 | Shkendie Papraniku | Nurse Practitioner | 6005 Park Ave Ste 510, Memphis, TN 38119-5215 | 2017-12-12 |
| 1063926079 | Megan Lee Alexander | Nurse Practitioner | 877 Jefferson Ave Fl 2, Memphis, TN 38103-2807 | 2017-11-29 |
| 1427568260 | Miranda D White | Nurse Practitioner | 6027 Walnut Grove Rd Ste 114, Memphis, TN 38120-2115 | 2017-10-06 |
| 1184098956 | Mika Tralayne Jackson | Nurse Practitioner | 4075 S Lakewood Dr, Memphis, TN 38128-4401 | 2015-11-17 |
| 1184009649 | Linda Fay Williams | Nurse Practitioner | 3655 Haughton Lane #2, Memphis, TN 38128 | 2015-07-27 |
| 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.