Individual provider Active NPI

Vernessa Lynn Davis-Tharpe, MD

  • Pediatrics Physician
  • Jackson, TN
National Provider Identifier
1275564866
Registry record updated May 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
21682 Issued in TN
Practice address
620 Skyline Dr FL 3
Jackson, TN 38301-3923
Phone
(866) 870-5570
Fax
(731) 541-8187
NPI assigned
Jul 5, 2006
Last updated
May 4, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 21682 TN
Family Medicine Physician 207Q00000X 21682 TN
Pediatrics Physician 208000000X 21682 TN Primary

Addresses

Primary practice location

620 Skyline Dr FL 3
Jackson, TN 38301-3923

Mailing address

850 Poplar Ave BLDG 2
Memphis, TN 38105-4607
Phone (901) 287-5594

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040518000526 TN Practitioner - Pediatric Medicine 5395735526 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
21682TNMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Healthcare-Memphis Hospitals Past Accepting new patients
West Tennessee Medical Group Inc Family Medicine Past Accepting new patients
WT Medical Associates Past Accepting new patients
Mid-South Perinatal Associates PC PastSince May 8, 2022 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: vdavistharpe34692@mlh.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651622400000",
    "number": "1275564866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 POPLAR AVE BLDG 2",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381054607",
            "telephone_number": "901-287-5594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 SKYLINE DR FL 3",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013923",
            "telephone_number": "866-870-5570",
            "fax_number": "731-541-8187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS-THARPE",
        "first_name": "VERNESSA",
        "middle_name": "LYNN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2022-05-04",
        "certification_date": "2022-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TN",
            "license": "21682",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "21682",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "21682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.