LATASIA TEDNORIA BRUNSON


Address: 2574 Frayser Blvd, Memphis, TN 38127-5829
Phone: 9013014361

LATASIA TEDNORIA BRUNSON (NPI# 1649777665) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1649777665
Entity Type Individual
Full Name LATASIA TEDNORIA BRUNSON
Credential B.A.
Practice Address 2574 Frayser Blvd
Memphis
TN 38127-5829
Mailing Address 6350 W Andrew Johnson Hwy
Talbott
TN 37877-8605
Practice Telephone 9013014361
Practice Fax Number 8653420121
Mailing Telephone 8003553565
Mailing Fax Number 4237142355
Enumeration Date 2018-04-06
Last Update Date 2018-04-06
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 171M00000X Case Manager/Care Coordinator Other Service Providers

Office Location

Street Address 2574 FRAYSER BLVD
City MEMPHIS
State TN
Zip Code 38127-5829

Providers in the same location

NPI Name Taxonomy Address Enumeration
1205820123 Tolan Vu Family Medicine 2574 Frayser Blvd, Memphis, TN 38127-5829 2005-09-07
1922605435 Vonetta Kentia Williams Nurse Practitioner 2574 Frayser Blvd, Memphis, TN 38127-5829 2020-10-07
1932712692 Darnesha Shundrika Mcgrew Nurse's Aide 2574 Frayser Blvd, Memphis, TN 38127-5829 2020-08-24
1861030926 Chandria Rae Houston Nurse's Aide 2574 Frayser Blvd, Memphis, TN 38127-5829 2019-12-19
1972141067 Teisha Lashae Pendleton Licensed Practical Nurse 2574 Frayser Blvd, Memphis, TN 38127-5829 2019-12-19
1386280964 Wilkena Dickerson Nurse's Aide 2574 Frayser Blvd, Memphis, TN 38127-5829 2019-11-19
1427691682 Angela Arnold Licensed Practical Nurse 2574 Frayser Blvd, Memphis, TN 38127-5829 2019-10-21
1275183246 Moniqua Toquana Hudson Licensed Practical Nurse 2574 Frayser Blvd, Memphis, TN 38127-5829 2019-09-12
1134789506 Nakia Danielle Stewart Licensed Practical Nurse 2574 Frayser Blvd, Memphis, TN 38127-5829 2019-06-18
1750940524 Tyesh Ward Nurse's Aide 2574 Frayser Blvd, Memphis, TN 38127-5829 2019-06-06
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1639660103 Jennifer Green Occupational Therapist 4209 Mtn.terrace, Memphis, TN 38127 2018-05-21
1891060570 Phylantyniese Lashunda Stone Non-emergency Medical Transport (VAN) 2790 N. Watkins, Memphis, TN 38127 2012-03-14
1982916326 Linda Faye Johnson Pharmacist 2655 Frayser Blvd., Memphis, TN 38127 2010-07-13
1215171046 M.g. Services, LLC Home Health 3065 Thomas St., Memphis, TN 38127 2009-04-23
1639325665 Dishman House Assisted Living Facility 3958 Cornell St., Memphis, TN 38127 2008-08-11
1467621334 Cet of Memphis, LLC Community/Behavioral Health 2470 Capewood Dr, Memphis, TN 38127 2008-02-26
1912074030 Medic Transportation, LLC. Ambulance 3180 Millington Rd., Memphis, TN 38127 2006-11-30
1609974450 Walgreen Co. Pharmacy 3100 Thomas St., Memphis, TN 38127 2006-09-20
1871541177 Clarice Weathers Mullinax Family Medicine 3124 North Thomas Street, Christ Community Health Services Inc, Memphis, TN 38127 2006-05-05
1295251619 Walgreen Co Durable Medical Equipment & Medical Supplies 2670 Frayser Blvd, Memphis, TN 38127 2017-08-17
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Taxonomy Information

Taxonomy Code 171M00000X
Grouping Other Service Providers
Classification Case Manager/Care Coordinator

Taxonomy Definition

A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management.
Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1447623202 Cordra Denise Childs Case Manager/Care Coordinator 1615 Cane Meadow Cir Apt 117, Memphis, TN 38106-6127 2015-11-02
1861877375 Jacqueline Webb Case Manager/Care Coordinator 685 Emerald View Way, Memphis, TN 38109-6385 2015-07-26
1063896686 Eboni Takendria Smith Case Manager/Care Coordinator 3993 Shinault Ln, Memphis, TN 38125-2649 2015-07-14
1750429437 Cheryl Ann Cole Case Manager/Care Coordinator 408 S Front St Apt 202, Memphis, TN 38103-4448 2007-02-02
1366002305 E3 Community Health/ Engage. Educate. Empower. Community Health Case Manager/Care Coordinator 5587 Murray Ave Ste 205, Memphis, TN 38119-0896 2019-06-20
1326533878 Kelcey Johnson Case Manager/Care Coordinator 82 N 2nd St, Memphis, TN 38103-2203 2018-06-27
1063916625 Mary Summers Case Manager/Care Coordinator 2600 Poplar Ave Ste 112, Memphis, TN 38112-3835 2018-03-20
1376057299 Jamaica Raffeal Ivery-glover Case Manager/Care Coordinator 2574 Frayser Blvd, Memphis, TN 38127-5829 2017-11-30
1023522752 Darius William Moravian Case Manager/Care Coordinator 4095 American Way Ste 1, Memphis, TN 38118-8339 2017-11-16
1396268157 Erika Marie Collins Case Manager/Care Coordinator 4095 American Way Ste 1, Memphis, TN 38118-8339 2017-07-24
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Competitor

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City MEMPHIS
Zip Code 38127

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Dataset Information

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.

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