Organization Active NPI

Kershaw Primary Care and Weight Loss, LLC

Doing business as Kershaw primary care and weight loss

  • Primary Care Nurse Practitioner
  • Memphis, TN
National Provider Identifier
1013525187
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
Legal business name
KERSHAW PRIMARY CARE AND WEIGHT LOSS, LLC
Doing business as
Kershaw primary care and weight loss
Practice address
6005 Park Ave Ste 826B
Memphis, TN 38119-5223
Phone
(901) 519-4680
NPI assigned
Jul 15, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2025

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

Authorized official

Name
Valarie Kershaw-BerryNPI 1407247315
Title
Over/Nurse Practitioner
Phone
(662) 902-9883

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X
Child & Adolescent Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0804X
Geriatric Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0805X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X
Primary Care Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP2300X Primary

Addresses

Primary practice location

6005 Park Ave Ste 826B
Memphis, TN 38119-5223

Mailing address

6005 Park Ave Ste 826B
Memphis, TN 38119-5223
Phone (901) 607-1292

Other names 1

  • Kershaw primary care and weight loss Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210217002662 TN Part B Supplier - Clinic/Group Practice 0840605275 Receives reassigned benefits from 1 practitioner
Practice locations: Memphis, TN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1594771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747094400000",
    "number": "1013525187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6005 PARK AVE STE 826B",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381195223",
            "telephone_number": "901-607-1292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6005 PARK AVE STE 826B",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381195223",
            "telephone_number": "901-519-4680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KERSHAW PRIMARY CARE AND WEIGHT LOSS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-15",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A",
        "authorized_official_last_name": "KERSHAW-BERRY",
        "authorized_official_first_name": "VALARIE",
        "authorized_official_title_or_position": "OVER/NURSE PRACTITIONER",
        "authorized_official_telephone_number": "662-902-9883"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kershaw primary care and weight loss",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kershaw primary care and weight loss",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.