Individual provider Active NPI

Angelica J Dennis, APN

  • Family Nurse Practitioner
  • Memphis, TN
National Provider Identifier
1003345398
Registry record updated Jun 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
22433 Issued in TN
Practice address
1265 Union
Memphis, TN 38104
Phone
(901) 516-8185
Fax
(901) 516-2077
NPI assigned
Jun 8, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 22433 TN Primary

Addresses

Primary practice location

1265 Union
Memphis, TN 38104

Mailing address

1265 Union Ave
Memphis, TN 38104-3415

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180924001847 TN Practitioner - Nurse Practitioner 5890046247 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Methodist Healthcare Community Care AssociatesGroup PAC ID 0941113757, 28 clinicians

Practice addresses (Care Compare)

8035 Club Pkwy
Cordova, TN 38016-5977
Phone (901) 758-6035

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Healthcare Community Care Associates CurrentSince Jul 17, 2018 Accepting new patients
Methodist Healthcare Community Care Associates Current Accepting new patients
Methodist Heatlhcare Community Care Associates CurrentSince Jul 17, 2018 Accepting new patients

Locations

8035 Club Pkwy
Cordova, TN 38016
Phone (901) 758-6035

8071 Winchester Rd
Memphis, TN 38125
Phone (901) 367-9001

1211 Union Ave
Ste 330
Memphis, TN 38104
Phone (901) 478-0954

Interoperability endpoints

  • Direct secure messaging: adennis22014@mlh.direct-ci.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1496880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496880000000",
    "number": "1003345398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1265 UNION AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381043415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 UNION",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38104",
            "telephone_number": "901-516-8185",
            "fax_number": "901-516-2077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENNIS",
        "first_name": "ANGELICA",
        "middle_name": "J",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-08",
        "last_updated": "2017-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "22433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.