Active NPI
Raven Myrick, CRNP
- Pediatric Nurse Practitioner
- Memphis, TN
National Provider Identifier
1265902613
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 27638
- Practice address
- 262 Danny Thomas PL
Memphis, TN 38105-3678 - Phone
- (901) 595-3300
- NPI assigned
- Nov 28, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 0000000 | AL | |
| Pediatric Nurse Practitioner | 363LP0200X | 27638 | TN | Primary |
Addresses
Primary practice location
262 Danny Thomas PL
Memphis, TN 38105-3678
Mailing address
262 Danny Thomas PL # Ms 515
Memphis, TN 38105-3678
Phone (901) 595-3300
Other practice location 1
1600 7th Ave S
Birmingham, AL 35233-1711
Phone (205) 638-9100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0000000 | AL | MD | Clinical Psychologist |
| 27638 | TN | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Alabama Health Services Foundation, PC. | Current | Accepting new patients | |
| University of Alabama Health Services Foundation, PC | Current | Accepting new patients |
Locations
703 Volker Hall
Birmingham, AL 35294
Phone (205) 638-9587
1600 7th Ave S
Birmingham, AL 35233
Phone (205) 638-9100
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.
-
- Multi-Specialty Clinic/Center
- Birmingham, AL
- NPI 1093768723
-
- Pediatrics Physician
- Birmingham, AL
- NPI 1356377576
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1543363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1749081600000",
"number": "1265902613",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "262 DANNY THOMAS PL # MS 515",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381053678",
"telephone_number": "901-595-3300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "262 DANNY THOMAS PL",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381053678",
"telephone_number": "901-595-3300"
}
],
"practiceLocations": [
{
"address_1": "1600 7th Ave S",
"address_purpose": "LOCATION",
"city": "Birmingham",
"state": "AL",
"postal_code": "352331711",
"country_code": "US",
"telephone_number": "205-638-9100",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MYRICK",
"first_name": "RAVEN",
"credential": "CRNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-11-28",
"last_updated": "2025-06-05",
"certification_date": "2025-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "AL",
"license": "0000000",
"primary": false
},
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "TN",
"license": "27638",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.