Active NPI
Regina Goulder, FNP-C
- Family Nurse Practitioner
- Atoka, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 18406
- Practice address
- 76 Capital Way
Suite C
Atoka, TN 38004-6832 - Phone
- (901) 840-1202
- Fax
- (901) 840-1204
- NPI assigned
- Feb 20, 2014
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 18406 | TN | Primary |
Addresses
Primary practice location
76 Capital Way
Suite C
Atoka, TN 38004-6832
Mailing address
1211 Union Ave Ste 330
Memphis, TN 38104-6655
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140409002371 | TN | Practitioner - Nurse Practitioner | 9436381241 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Primary Care Group, LLC
Practice addresses (Care Compare)
2961 Canada Rd
Suite 105
Lakeland, TN 38002-4893
Phone (901) 388-0115
Hospital & facility affiliations
- Beacon Home Health
- Tennessee Quality Care - Home Health
- Adoration Home Health Brownsville
- Methodist Hospitals of Memphis
- Baptist Memorial Hospital Tipton
- Baptist Memorial Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Primary Care Group LLC | Family | Current | Accepting new patients |
Locations
76 Capital Way
Ste C
Atoka, TN 38004
Phone (901) 837-6674
8035 Club Pkwy
Cordova, TN 38016
Phone (901) 758-6035
2961 Canada Rd
Ste 105
Lakeland, TN 38002
Phone (901) 388-0115
1211 Union Ave
Ste 700
Memphis, TN 38104
Phone (901) 287-5182
1211 Union Ave
Ste 330
Memphis, TN 38104
Phone (901) 478-0954
Interoperability endpoints
- rgoulder32153@mlh.direct-ci.com
Organizations & group practices 1
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.
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Brownsville, TN
- NPI 1639659675
-
- Home Health Agency
- Memphis, TN
- NPI 1114975539
-
- General Acute Care Hospital
- Memphis, TN
- NPI 1558365890
Hospital
-
- Home Health Agency
- Parsons, TN
- NPI 1396702536
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1392854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747094400000",
"number": "1295150787",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1211 UNION AVE STE 330",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381046655"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "76 CAPITAL WAY",
"address_2": "SUITE C",
"city": "ATOKA",
"state": "TN",
"postal_code": "380046832",
"telephone_number": "901-840-1202",
"fax_number": "901-840-1204"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOULDER",
"first_name": "REGINA",
"credential": "FNP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-02-20",
"last_updated": "2025-05-13",
"certification_date": "2025-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TN",
"license": "18406",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Atoka, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.