Active NPI
Yen Pham Farmer, FNP-BC
- Family Nurse Practitioner
- Southaven, MS
National Provider Identifier
1083902613
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- R896239
- Practice address
- 7276 Southcrest Pkwy
Southaven, MS 38671-4760 - Phone
- (662) 349-6577
- Fax
- (662) 349-6562
- NPI assigned
- Jul 18, 2011
- Last updated
- Aug 4, 2023
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R896239 | MS | Primary |
Addresses
Primary practice location
7276 Southcrest Pkwy
Southaven, MS 38671-4760
Mailing address
7276 Southcrest Pkwy
Southaven, MS 38671-4760
Phone (662) 349-6577
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R896239 | MS | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spinal Health Care Associates, P.C. | Past | Accepting new patients | |
| Sidhu Pediatrics, LLC | Past | Accepting new patients | |
| Sidhu Pediatrics, LLC | Past | Accepting new patients | |
| Memphis & Shelby County Pediatric Group | Past | Accepting new patients | |
| Memphis & Shelby County Ped. Group | Past | Accepting new patients | |
| Memphis Spine and Rehab Center, PLLC | Past | Accepting new patients | |
| Sidhu Pediatrics, LLC | Past | Accepting new patients |
Organizations & group practices 7
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Desoto Children's Clinic - Southaven
- Pediatrics Physician
- Southaven, MS
- NPI 1326261843
-
dba Senatobia Children's Clinic
- Pediatrics Physician
- Senatobia, MS
- NPI 1336369156
-
dba Desoto Children's Clinic - Olive Branch
- Pediatrics Physician
- Olive Branch, MS
- NPI 1891179768
-
- Pediatrics Physician
- Memphis, TN
- NPI 1710067020
-
- Pediatric Adolescent Medicine Physician
- Memphis, TN
- NPI 1487797536
-
- Multi-Specialty Clinic/Center
- Memphis, TN
- NPI 1811304439
-
- Rehabilitation Chiropractor
- Cordova, TN
- NPI 1316137243
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1310947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691107200000",
"number": "1083902613",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7276 SOUTHCREST PKWY",
"city": "SOUTHAVEN",
"state": "MS",
"postal_code": "386714760",
"telephone_number": "662-349-6577"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7276 SOUTHCREST PKWY",
"city": "SOUTHAVEN",
"state": "MS",
"postal_code": "386714760",
"telephone_number": "662-349-6577",
"fax_number": "662-349-6562"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FARMER",
"first_name": "YEN",
"middle_name": "PHAM",
"credential": "FNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-07-18",
"last_updated": "2023-08-04",
"certification_date": "2023-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MS",
"license": "R896239",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Southaven, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.