Individual provider Active NPI

Mary Rafaela Morrison, PMHNP- BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Memphis, TN
National Provider Identifier
1104296508
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F405457-01 Issued in NY
Practice address
951 Court Ave
Memphis, TN 38103-2813
Phone
(901) 577-9400
NPI assigned
Sep 29, 2015
Reactivated
Nov 22, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 35276 TN
Psychiatric/Mental Health Nurse Practitioner 363LP0808X F405457-01 NY Primary

Addresses

Primary practice location

951 Court Ave
Memphis, TN 38103-2813

Mailing address

951 Court Ave
Memphis, TN 38103-2813

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, TN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240215003956 NY Practitioner - Nurse Practitioner 7113361361
I20240524002697 TN Practitioner - Nurse Practitioner 7113361361 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alliance Healthcare ServicesGroup PAC ID 4082766621, 28 clinicians

Practice addresses (Care Compare)

951 Court Ave
Memphis, TN 38103-2813
Phone (901) 353-5440

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35276TNMDFamily Medicine Physician
F405457-01NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Healthcare Services CurrentSince Apr 8, 2024 Accepting new patients
Grow Healthcare Group PA Psychiatric/Mental Health CurrentSince Jun 3, 2025 Accepting new patients
Midsouth Medication Management PLLC Psychiatric/Mental Health Current Accepting new patients
Alliance Healthcare Services CurrentSince Apr 8, 2024 Accepting new patients
Alliance Healthcare Services Broad Pharmacy PastSince Apr 6, 2025 Accepting new patients

Locations

951 Court Ave
Memphis, TN 38103
Phone (901) 577-1800

2673 Yale Ave
Memphis, TN 38112
Phone (901) 262-4112

2150 Whitney Ave
Memphis, TN 38127
Phone (901) 353-5440

3200 Broad Ave
Memphis, TN 38112
Phone (901) 577-9400

2220 Union Ave
Memphis, TN 38104
Phone (901) 369-1480

3810 Winchester Rd
Memphis, TN 38118
Phone (901) 369-1400

40 Burton Hills Blvd
Ste 200
Nashville, TN 37215
Phone (615) 257-8410

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1443484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1104296508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "951 COURT AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381032813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "951 COURT AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381032813",
            "telephone_number": "901-577-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRISON",
        "first_name": "MARY RAFAELA",
        "credential": "PMHNP- BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-29",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-21",
        "deactivation_date": "2016-07-07",
        "reactivation_date": "2023-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "35276",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F405457-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.