Individual provider Active NPI

Tamaria Johnson, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Cordova, TN
National Provider Identifier
1104771872
Registry record updated Feb 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
40963 Issued in TN
Practice address
8407 Trondheim Dr
Cordova, TN 38018-4383
Phone
(901) 652-9989
NPI assigned
Feb 27, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 40963 TN Primary

Addresses

Primary practice location

8407 Trondheim Dr
Cordova, TN 38018-4383

Mailing address

8407 Trondheim Dr
Cordova, TN 38018-4383
Phone (901) 652-9989

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20260410000752 TN Practitioner - Nurse Practitioner 4082189790 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

7877 Willow Chase Blvd
Houston, TX 77070-5934

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40963TNMDPsychiatric/Mental Health Nurse Practitioner

Organizations & group practices 2

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": "1772150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772150400000",
    "number": "1104771872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8407 TRONDHEIM DR",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380184383",
            "telephone_number": "901-652-9989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8407 TRONDHEIM DR",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380184383",
            "telephone_number": "901-652-9989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TAMARIA",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-02-27",
        "last_updated": "2026-02-27",
        "certification_date": "2026-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "40963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cordova, TN

Sources for this page

Verify at the official NPI Registry.