Mary Ann Clevenger, NURSE PRACTIONER

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1039114 Issued in KY

Practice address

2643 Appling Glen Dr
Memphis, TN 38133-5228

Phone

(901) 849-1722

NPI assigned

Aug 12, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1660262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660262400000",
    "number": "1093443491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2643 APPLING GLEN DR",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381335228",
            "telephone_number": "901-849-1722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2643 APPLING GLEN DR",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381335228",
            "telephone_number": "901-849-1722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEVENGER",
        "first_name": "MARY",
        "middle_name": "ANN",
        "credential": "NURSE PRACTIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-12",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "1039114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Clermont
• Ajigne Cleveland, FNP-C
• Jeffrey Alan Cleveland, PHARMD
• Kerry O Cleveland, MD
• Kevin B Cleveland, M.D.
• Anna Catherinie Click
• Clifford W Sims MD PC
• Judy Kay Clifft, PT
• Devon Ellis Clifton, MD
• Clinic LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2022; 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.