Individual provider Active NPI

Persephone A Burnett

  • Family Nurse Practitioner
  • Germantown, TN
National Provider Identifier
1366069551
Registry record updated Apr 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
27468 Issued in TN
Practice address
7655 Poplar Ave Ste 350
Germantown, TN 38138-4933
Phone
(901) 761-2470
Fax
(901) 767-4898
NPI assigned
Jul 3, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 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 27468 TN Primary

Addresses

Primary practice location

7655 Poplar Ave Ste 350
Germantown, TN 38138-4933

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
I20200916001337 TN Practitioner - Nurse Practitioner 2365860798 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Specialty Physician Group LLCGroup PAC ID 9537291323, 101 clinicians

Practice addresses (Care Compare)

7655 Poplar Ave
Suite 350
Germantown, TN 38138-4933
Phone (901) 761-2470

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Specialty Physician Group LLC Family CurrentSince Sep 1, 2020 Accepting new patients

Locations

1325 Eastmoreland Ave
Ste 365
Memphis, TN 38104
Phone (901) 272-6018

7655 Poplar Ave
Ste 350
Memphis, TN 38138
Phone (901) 759-3447

7460 Wolf River Blvd
Memphis, TN 38138
Phone (901) 516-6792

1211 Union Ave
Ste 330
Memphis, TN 38104
Phone (901) 478-0954

Interoperability endpoints

  • Direct secure messaging: pburnett31610@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 3

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": "1593734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745193600000",
    "number": "1366069551",
    "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": "7655 POPLAR AVE STE 350",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381384933",
            "telephone_number": "901-761-2470",
            "fax_number": "901-767-4898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNETT",
        "first_name": "PERSEPHONE",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-03",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "27468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, TN

Sources for this page

Verify at the official NPI Registry.