MRS. JOHNNA KAYE YEALY (NPI# 1871604488) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871604488 |
| Entity Type | Individual |
| Full Name | MRS. JOHNNA KAYE YEALY |
| Other Name | JOHNNA TANNER |
| Credential | PA-C |
| Practice Address |
930 Madison Ave Suite 890 Memphis TN 38103-3410 |
| Mailing Address |
2157 Idlewood Cv Germantown TN 38139-5316 |
| Practice Telephone | 9018668834 |
| Practice Fax Number | 9013022834 |
| Mailing Telephone | 6159709212 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2015-01-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA1377 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | TC 015 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | TN STATE LICENSE | PA1377 | 01 |
| Street Address |
930 MADISON AVE SUITE 890 |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38103-3410 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124002175 | M. Barry Randall | Pathology | 930 Madison Ave, Suite 890, Memphis, TN 38103-3410 | 2005-12-02 |
| 1194186387 | Kimberly Carter | Physical Therapist | 930 Madison Ave, Room 658, Memphis, TN 38163-2243 | 2016-03-15 |
| 1376964494 | Anne Zachry | Occupational Therapist | 930 Madison Ave, Suite Ec013, Memphis, TN 38163-2243 | 2013-12-16 |
| 1881036598 | Roberta Lynn Gatlin | Physical Therapist | 930 Madison Ave, Suite Ec013, Memphis, TN 38163-2243 | 2013-07-23 |
| 1831531540 | Matthew Webb | Physical Therapist | 930 Madison Ave, Suite Ec013, Memphis, TN 38163-2243 | 2013-07-23 |
| 1851638340 | Jacque L Bradford | Physical Therapist | 930 Madison Ave, Memphis, TN 38103-3410 | 2013-01-03 |
| 1922304278 | Barbara Jean Jennings | Optometrist | 930 Madison Ave, Suite 731, Memphis, TN 38103-3410 | 2011-02-03 |
| 1548429707 | Alinda Guynes Mcgowin | Ophthalmology | 930 Madison Ave, Suite 200, Memphis, TN 38103-3410 | 2008-06-03 |
| 1013186873 | Andrzej T Slominski | Pathology | 930 Madison Ave, Suite 500, Memphis, TN 38103-3410 | 2008-02-26 |
| 1306049879 | Pamela D Ritzline | Physical Therapist | 930 Madison Ave, Suite 640, Memphis, TN 38163-2243 | 2007-06-11 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619505724 | Michelle Lynn Esposito | Dietitian, Registered | 1st Floor Research Center - 50 North Dunlap St, Memphis, TN 38103 | 2020-04-01 |
| 1962030221 | Allison Burge Clayton | Dietitian, Registered | 50 N Dunlap, Nutrition Therapy Dept, 1st Floor Research Tower, Memphis, TN 38103 | 2020-03-31 |
| 1093375420 | Radar Ems, LLC | Social Worker | 50 S. B.b. King Blvd, Suite 350, Memphis, TN 38103 | 2019-06-18 |
| 1528529021 | Denise Andrews Matthews | Nursing Care | 342 Island Dr #105, Memphis, TN 38103 | 2019-03-27 |
| 1881160059 | Christopher Paul Hernandez | Nurse Practitioner | 877 Jeffeon Ave, Memphis, TN 38103 | 2018-10-15 |
| 1194245712 | Cameron Waters Clinard | Optometrist | 127 Isle Creek Dr, Memphis, TN 38103 | 2017-06-24 |
| 1750732582 | Amanda Leigh Eaves | Nurse Practitioner | 364 S Front St Ste 201, Memphis, TN 38103 | 2016-06-22 |
| 1417304569 | John Clark Shell | Family Medicine | 150 Harbor Creek Dr, Memphis, TN 38103 | 2016-05-18 |
| 1750753695 | Tomisha V. Byard | Nurse Practitioner | 718 Habor Bend Road, Memphis, TN 38103 | 2015-10-29 |
| 1053795179 | Melissa Anne Wilkes | Social Worker | 1240 Harbor River Drive, Memphis, TN 38103 | 2015-07-18 |
| Find all providers in zip 38103 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235737354 | Adrienne Smith | Physician Assistant | 5200 Park Ave Ste 100, Memphis, TN 38119-3505 | 2020-10-12 |
| 1134734817 | Siushan Tang Vuong | Physician Assistant | 102 Clark Pl Apt S, Memphis, TN 38104-2419 | 2020-09-10 |
| 1174137525 | Gustavo Adolfo Tangarife Sr. | Physician Assistant | 2193 Morning Vista Dr, Memphis, TN 38134-6018 | 2020-09-02 |
| 1053949586 | Michella Glenna Douglas | Physician Assistant | 3911 Oak Branch Cir W, Memphis, TN 38135-0213 | 2020-03-30 |
| 1619508942 | Victoria Mackay | Physician Assistant | 595 Danny Thomas Place, Memphis, TN 38105 | 2020-01-27 |
| 1306480868 | Lauren Blum | Physician Assistant | 100 S Greer St, Memphis, TN 38111-3429 | 2019-10-28 |
| 1487135463 | Baron Surgical, Pllc | Physician Assistant | 4728 Spottswood Ave # 199, Memphis, TN 38117-4817 | 2018-08-27 |
| 1083139265 | Huda Alaeddin | Physician Assistant | 6584 Poplar Ave Ste 400, Memphis, TN 38138-3687 | 2017-08-08 |
| 1982076246 | Richard Randolph | Physician Assistant | 1094 River Isle Dr, Memphis, TN 38103-8870 | 2015-10-27 |
| 1962870808 | Sophia Garrison | Physician Assistant | 4562 Poplar Ave Ste 109, Memphis, TN 38117-7515 | 2015-09-09 |
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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.