LISSA NICOLE ROUX (NPI# 1902151095) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902151095 |
| Entity Type | Individual |
| Full Name | LISSA NICOLE ROUX |
| Credential | FNP |
| Practice Address |
2400 Poplar Ave Suite 501 Memphis TN 38112-3213 |
| Mailing Address |
2595 Central Ave Memphis TN 38104-5905 |
| Practice Telephone | 9017012580 |
| Practice Fax Number | 9012608449 |
| Mailing Telephone | 9012608500 |
| Mailing Fax Number | 9012608598 |
| Enumeration Date | 2012-07-16 |
| Last Update Date | 2015-03-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | R881642 | MS | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
16791 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 1529003 | 05 |
| Street Address |
2400 POPLAR AVE SUITE 501 |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38112-3213 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912418302 | Linda Marie Jones | Nurse Practitioner | 2400 Poplar Ave, Memphis, TN 38112-3213 | 2017-10-12 |
| 1003287756 | Key Behavior Essentials LLC | Counselor | 2400 Poplar Ave, 350, Memphis, TN 38112-3213 | 2015-10-07 |
| 1033527213 | Talea Brown | Nurse Practitioner | 2400 Poplar Ave, Suite 501, Memphis, TN 38112-3213 | 2014-07-31 |
| 1457695538 | James Robert Ward | Counselor | 2400 Poplar Ave, Memphis, TN 38112-3213 | 2012-11-15 |
| 1770863557 | Christ Community Health Services Inc | Clinic/Center | 2400 Poplar Ave, Memphis, TN 38112-3213 | 2011-08-24 |
| 1568602043 | Virginia F. Hood | Social Worker | 2400 Poplar Ave, Suite 318, Memphis, TN 38112-3213 | 2009-02-24 |
| 1962669317 | Kimberly Michelle Higgs | Social Worker | 2400 Poplar Ave, Suite 318, Memphis, TN 38112-3213 | 2008-05-21 |
| 1427234764 | Katherine Cherry Liu | Obstetrics & Gynecology | 2400 Poplar Ave, Suite 501, Memphis, TN 38112-3213 | 2008-01-17 |
| 1689860553 | Quest Diagnostics Clinical Laboratories Inc | Clinical Medical Laboratory | 2400 Poplar Ave, Suite 210, Memphis, TN 38112 | 2007-09-24 |
| 1154513208 | Emily Susan Moffatt | Social Worker | 2400 Poplar Ave, Suite 318, Memphis, TN 38112-3213 | 2007-08-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316427602 | Chs Tennessee Medical P C | Clinic/Center | 2680 Pershing Ave, Memphis, TN 38112 | 2018-08-16 |
| 1457688798 | Ethan Martin Langston | Counselor | 2714 Union Extended, Suite 400, Memphis, TN 38112 | 2009-11-06 |
| 1033345756 | Marquita Lachelle Little | Counselor | 2714 Union Avenue Extension, Suite 400, Memphis, TN 38112 | 2009-06-09 |
| 1366689481 | Open Hand Trans | Non-emergency Medical Transport (VAN) | 2600 Poplar Avenue 325, Memphis, TN 38112 | 2009-01-12 |
| 1952562696 | Christ Community Health Services Inc | Clinic/Center | 2861 Broad Avenue, Christ Community Health Services,inc, Memphis, TN 38112 | 2008-06-24 |
| 1013117225 | Yolanda Anthony-west | Dentist | 1045 Mullins Station Road, Memphis, TN 38112 | 2007-07-25 |
| 1083754634 | Trillium Womancare LLC | Advanced Practice Midwife | 2610 Autumn Avenue, Memphis, TN 38112 | 2007-02-06 |
| 1013066596 | Health Tech Affiliates | Counselor | 2670 Union Extended, Suite 610, Memphis, TN 38112 | 2007-01-10 |
| 1730238320 | James Matthew Doyle | Counselor | 2670 Union Extd Suite 610, Concern Eap, Memphis, TN 38112 | 2007-01-10 |
| 1619025087 | Nancy Whitman Manire | Social Worker | 2670 Union Ext, Suite 610, Memphis, TN 38112 | 2007-01-08 |
| Find all providers in zip 38112 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730787193 | Nancy Katherine Ray | Nurse Practitioner | 4576 Poplar Ave, Memphis, TN 38117-7502 | 2020-10-16 |
| 1245837533 | Sandra Dee Garrison | Nurse Practitioner | 335 Lillian Dr, Memphis, TN 38109-4431 | 2020-10-08 |
| 1972119527 | Oneka E Poindexter | Nurse Practitioner | 86 N Rembert St, Memphis, TN 38104-2766 | 2020-09-18 |
| 1295346260 | Jimarie Nelson | Nurse Practitioner | 5100 Poplar Ave Ste 2007, Memphis, TN 38137-2007 | 2020-08-13 |
| 1346869187 | Tollaria Williams | Nurse Practitioner | 3797 Old Waverly Cv Apt 201, Memphis, TN 38125-2678 | 2020-04-12 |
| 1497388912 | Michelle Denise Jones | Nurse Practitioner | 493 Doctor M.l.k. Jr Ave, Memphis, TN 38126-3812 | 2020-02-13 |
| 1336781657 | J Wilson Health LLC | Nurse Practitioner | 5100 Poplar Ave, Fl 27 Ste 2719a, Memphis, TN 38137-2701 | 2019-10-09 |
| 1265081574 | Natalie Staten | Nurse Practitioner | 7651 Shelby Forest Cv, Memphis, TN 38125-2822 | 2019-09-09 |
| 1881247740 | Mekeilah Nevaun Johnson | Nurse Practitioner | 6005 Park Ave Ste 825b, Memphis, TN 38119-5223 | 2019-07-19 |
| 1205488087 | Wendy Powell | Nurse Practitioner | 1407 Union Ave Ste 405, Memphis, TN 38104-3627 | 2019-07-12 |
| 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.