Individual provider Active NPI

Regina Goulder, FNP-C

  • Family Nurse Practitioner
  • Atoka, TN
National Provider Identifier
1295150787
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
18406 Issued in TN
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

Updated by the provider on May 13, 2025

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 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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, LLCGroup PAC ID 0941480131, 108 clinicians

Practice addresses (Care Compare)

2961 Canada Rd
Suite 105
Lakeland, TN 38002-4893
Phone (901) 388-0115

Hospital & facility affiliations

  • Beacon Home Health Home health agency, Memphis, TN, CCN 447277
  • Tennessee Quality Care - Home Health Home health agency, Parsons, TN, CCN 447402
  • Adoration Home Health Brownsville Home health agency, Brownsville, TN, CCN 447503
  • Methodist Hospitals of Memphis Hospital, Memphis, TN, CCN 440049
  • Baptist Memorial Hospital Tipton Hospital, Covington, TN, CCN 440131
  • Baptist Memorial Hospital Hospital, Memphis, TN, CCN 440048

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care Group LLC Family CurrentSince Aug 6, 2015 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.