MRS. ANGELA MARIE CISSOM (NPI# 1891045282) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891045282 |
| Entity Type | Individual |
| Full Name | MRS. ANGELA MARIE CISSOM |
| Credential | AUD |
| Practice Address |
4646 Poplar Ave Suite 100 Memphis TN 38117-4426 |
| Practice Telephone | 9017620125 |
| Practice Fax Number | 9018183001 |
| Mailing Telephone | 9017620125 |
| Mailing Fax Number | 9018183001 |
| Enumeration Date | 2012-09-13 |
| Last Update Date | 2016-11-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 231H00000X | Audiologist | 01274 | MD | Speech, Language and Hearing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | STATE OF TENNESSEE DEPARTMENT OF HEALTH DIVISION OF HEALTH RELAT | 1726 | 01 |
| Street Address |
4646 POPLAR AVE SUITE 100 |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38117-4426 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568438505 | James B Moseley | Psychiatry & Neurology | 4646 Poplar Ave, Suite 317, Memphis, TN 38117-4426 | 2006-02-28 |
| 1194299859 | Novia Wright | Social Worker | 4646 Poplar Ave, Memphis, TN 38117-4426 | 2019-01-16 |
| 1285135079 | Erica Nicole Liddell | Counselor | 4646 Poplar Ave, Memphis, TN 38117 | 2018-02-27 |
| 1073020244 | Danielle Janae Neal | Counselor | 4646 Poplar Ave, Memphis, TN 38117-4426 | 2018-01-09 |
| 1174044200 | Leslie D Halpern | Social Worker | 4646 Poplar Ave, Memphis, TN 38117-4426 | 2017-06-28 |
| 1588108344 | Umieca Nicolle Hankton | Psychologist | 4646 Poplar Ave, Ste 543, Memphis, TN 38117-4426 | 2016-12-14 |
| 1770036303 | Healing Hearts Counseling Center | Community/Behavioral Health | 4646 Poplar Ave, Ste 543, Memphis, TN 38117-4426 | 2016-08-01 |
| 1750730768 | Jessica Seebeck | Counselor | 4646 Poplar Ave, Memphis, TN 38117-4426 | 2016-06-09 |
| 1013377241 | Taylor & Steer Enterprises Inc | Audiologist-Hearing Aid Fitter | 4646 Poplar Ave, Suite 100, Memphis, TN 38117-4426 | 2016-03-01 |
| 1336531987 | Counseling and Testing Services | Counselor | 4646 Poplar Ave, Suite 417, Memphis, TN 38117-4426 | 2015-02-19 |
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| 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 | 231H00000X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Audiologist |
| (1) A specialist in evaluation, habilitation and rehabilitation of those whose communication disorders center in whole or in part in hearing function. Audiologists are autonomous professionals who identify, assess, and manage disorders of the auditory, balance and other neural systems. Audiologists provide audiological (aural) rehabilitation to children and adults across the entire age span. Audiologists select, fit and dispense amplification systems such as hearing aids and related devices. (2) An audiologist is a person qualified by a master’s degree in audiology, licensed by the state, where applicable, and practicing within the scope of that license. Audiologists evaluate and treat patients with impaired hearing. They plan, direct and conduct rehabilitative programs with audiotry substitutional devises (hearing aids) and other therapy. |
| Notes: Source: (1) American Speech-Language-Hearing Association, (1996, Spring) Scope of practice in Audiology, p. 2 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144881806 | Emma Bailey | Audiologist | 6025 Walnut Grove Rd Dept C-1011, Memphis, TN 38120-2131 | 2019-06-24 |
| 1629635040 | Virginia Acosta | Audiologist | 1030 Jefferson Ave # 112h, Memphis, TN 38104-2127 | 2019-05-21 |
| 1417415100 | Anna Westling Ingram | Audiologist | 51 N Dunlap St # G10, Memphis, TN 38105-4624 | 2019-03-12 |
| 1679031355 | Cynthia Gore | Audiologist | 51 N Dunlap St Ste G-10, Memphis, TN 38105-4624 | 2019-03-12 |
| 1619415338 | Memphis Audiology | Audiologist | 380 N Island Dr, 304, Memphis, TN 38103-9049 | 2017-02-01 |
| 1366791949 | Jennifer Denyes Bidelman | Audiologist | 5625 Poplar Avenue, Memphis, TN 38119 | 2012-08-29 |
| 1710247499 | Shannon Knox | Audiologist | 6616 Kirby Center Cv, Memphis, TN 38115-4313 | 2012-05-29 |
| 1023389657 | Holley-marie Biggs | Audiologist | 4075 Park Ave, Memphis, TN 38111-7420 | 2012-01-12 |
| 1164729562 | Carolyn North Mcwatters | Audiologist | 6025 Walnut Grove Rd Ste 210, Memphis, TN 38120-2122 | 2011-02-21 |
| 1639320823 | Melissa Renfrow Taylor | Audiologist | 6025 Walnut Grove Rd Ste C-1011, Memphis, TN 38120-2131 | 2008-10-06 |
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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.