Active NPI
Faith Fraser, REV
- Home Health Agency
- Memphis, TN
National Provider Identifier
1063833622
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Practice address
- 5390 Loch Lomond Rd
Memphis, TN 38116-9049 - Phone
- (901) 321-5511
- NPI assigned
- Dec 30, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Primary |
Addresses
Primary practice location
5390 Loch Lomond Rd
Memphis, TN 38116-9049
Mailing address
5390 Loch Lomond Rd
Memphis, TN 38116-9049
Phone (901) 321-5511
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 206040 | Other | WI | STATE CERTIFICATION |
| 00145595 | Other | TN | STATE CERTIFICATION |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1388361600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1388361600000",
"number": "1063833622",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5390 LOCH LOMOND RD",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381169049",
"telephone_number": "901-321-5511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5390 LOCH LOMOND RD",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381169049",
"telephone_number": "901-321-5511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRASER",
"first_name": "FAITH",
"credential": "REV",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-12-30",
"last_updated": "2013-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE CERTIFICATION",
"identifier": "206040",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE CERTIFICATION",
"identifier": "00145595",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}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 Dec 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.