Individual provider Active NPI

Tanecia Oliver, FNP-C

  • Family Nurse Practitioner
  • Cordova, TN
National Provider Identifier
1154036721
Registry record updated Jan 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
33882 Issued in TN
Practice address
670 N Germantown Pkwy Ste 18
Cordova, TN 38018-6287
Phone
(901) 753-7686
NPI assigned
Jan 18, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 33882 TN Primary

Addresses

Primary practice location

670 N Germantown Pkwy Ste 18
Cordova, TN 38018-6287

Mailing address

965 Ridge Lake Blvd
Memphis, TN 38120-9401
Phone (901) 227-4692

Other identifiers 1

IdentifierTypeStateIssuer
F01230017MedicaidTN

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
I20240321000487 TN Practitioner - Nurse Practitioner 1456798867 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Memorial Medical Group, Inc.Group PAC ID 5193610228, 581 clinicians
Baptist Minor Medical Centers IncGroup PAC ID 9032010715, 3 clinicians

Practice addresses (Care Compare)

2100 Exeter Rd
Germantown, TN 38138-3966
Phone (901) 757-3424

3295 Poplar Ave
Suite 105
Memphis, TN 38111-4690
Phone (901) 327-8188

670 N Germantown Pkwy
Suite 18
Cordova, TN 38018-6287
Phone (901) 753-7686

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
33882TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Minor Medical Centers Inc Family CurrentSince Mar 8, 2024 Accepting new patients
Baptist Memorial Medical Group Inc PastSince Jan 28, 2024 Accepting new patients
Southeastern Emergency Physicians of Memphis LLC Past Accepting new patients

Locations

670 N Germantown Pkwy
Ste 18
Cordova, TN 38018
Phone (901) 753-7686

3295 Poplar Ave
Ste 105
Memphis, TN 38111
Phone (901) 327-8188

Interoperability endpoints

  • Direct secure messaging: toliver608521@direct.bmhcc.org

Organizations & group practices 6

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": "1674000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706054400000",
    "number": "1154036721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 RIDGE LAKE BLVD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209401",
            "telephone_number": "901-227-4692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 N GERMANTOWN PKWY STE 18",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380186287",
            "telephone_number": "901-753-7686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVER",
        "first_name": "TANECIA",
        "name_prefix": "Miss",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-18",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "33882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "F01230017",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cordova, TN

Sources for this page

Verify at the official NPI Registry.