Organization Active NPI

Natural Potential Health and Wellness PLLC

  • Family Nurse Practitioner
  • Collierville, TN
National Provider Identifier
1093461360
Registry record updated Mar 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
NATURAL POTENTIAL HEALTH AND WELLNESS PLLC
Practice address
2028 W Poplar Ave Ste 106
Collierville, TN 38017-0618
Phone
(901) 861-0716
Fax
(901) 861-0718
NPI assigned
Feb 25, 2022
Last updated
Mar 14, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2022

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

Authorized official

Name
Dr. Jeffrey CarrNPI 1225271265
Title
Owner
Phone
(901) 861-0716

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

2028 W Poplar Ave Ste 106
Collierville, TN 38017-0618

Mailing address

2028 W Poplar Ave Ste 106
Collierville, TN 38017-0618
Phone (901) 861-0716

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250924002246 TN Part B Supplier - Clinic/Group Practice 7618472325 Receives reassigned benefits from 3 practitioners
Practice locations: Collierville, TN

National Provider Directory

National Provider Directory

Locations

2028 W Poplar Ave
Ste 106
Collierville, TN 38017
Phone (901) 861-0178

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1645747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647216000000",
    "number": "1093461360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2028 W POPLAR AVE STE 106",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380170618",
            "telephone_number": "901-861-0716",
            "fax_number": "901-861-0718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2028 W POPLAR AVE STE 106",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380170618",
            "telephone_number": "901-861-0716",
            "fax_number": "901-861-0718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATURAL POTENTIAL HEALTH AND WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-25",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-14",
        "status": "A",
        "authorized_official_last_name": "CARR",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "901-861-0716",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Collierville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2022; 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.