NPIMap

Organization Active NPI

Hidden Paths, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Germantown, TN
National Provider Identifier
1316775323
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
HIDDEN PATHS, LLC
Practice address
7516 Enterprise Ave # 1
Germantown, TN 38138-3802
Phone
(901) 757-2249
NPI assigned
Jul 22, 2024
Last updated
Jul 22, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Authorized official

Name
Mr. Jeffrey Banham, DNP, APRN, FNP-CNPI 1477078962
Title
Owner
Phone
(901) 216-4354

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU Primary

Addresses

Primary practice location

7516 Enterprise Ave # 1
Germantown, TN 38138-3802

Mailing address

PO Box 269
Ellendale, TN 38029-0269
Phone (901) 216-4354

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241018000267 TN Part B Supplier - Clinic/Group Practice 7618409335 Receives reassigned benefits from 1 practitioner
Practice locations: Germantown, TN

National Provider Directory

National Provider Directory

Locations

7516 Enterprise Ave
#2
Germantown, TN 38138
Phone (901) 216-4354

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1721606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721606400000",
    "number": "1316775323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 269",
            "city": "ELLENDALE",
            "state": "TN",
            "postal_code": "380290269",
            "telephone_number": "901-216-4354",
            "fax_number": "888-858-1577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7516 ENTERPRISE AVE # 1",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381383802",
            "telephone_number": "901-757-2249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIDDEN PATHS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-22",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A",
        "authorized_official_last_name": "BANHAM",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "901-216-4354",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DNP, APRN, FNP-C"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.