Impact Midsouth Inc.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

IMPACT MIDSOUTH INC.

Practice address

4512 Trout Valley Dr
Memphis, TN 38141-7724

Phone

(901) 584-8165

NPI assigned

Nov 3, 2025

Organization subpart

No

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

Authorized official

Name

Marquita Williams, NPNPI 1669912127

Title

Owner

Phone

(901) 584-8165

Specialties & licenses 1

Addresses

Practitioners 1

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

• Marquita Williams

  • Family Nurse Practitioner
  • Collierville, TN
  • NPI 1669912127
  NPD Authorized official

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

{
    "created_epoch": "1762128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762128000000",
    "number": "1033088422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3169 PLAYERS CLUB PKWY",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381258835",
            "telephone_number": "901-584-8165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4512 TROUT VALLEY DR",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381417724",
            "telephone_number": "901-584-8165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT MIDSOUTH INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-03",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-03",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "MARQUITA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "901-584-8165",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Memphis, TN
• Providers in Memphis, TN by specialty
• Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.