Organization Active NPI

My Clinic Memphis, LLC

Doing business as My Clinic Memphis

  • Primary Care Clinic/Center
  • Memphis, TN
National Provider Identifier
1366234023
Registry record updated Mar 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
MY CLINIC MEMPHIS, LLC
Doing business as
My Clinic Memphis
Practice address
4901 Raleigh Common Dr Ste 100
Memphis, TN 38128-2478
Phone
(901) 545-4331
NPI assigned
May 20, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2026

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

Authorized official

Name
Elisheva Reese, MSN, APRN, FNP-BCNPI 1528422441
Title
Family Nurse Practitioner / Owner
Phone
(901) 545-4331

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary
Research Clinic/Center 261QR1100X

Addresses

Primary practice location

4901 Raleigh Common Dr Ste 100
Memphis, TN 38128-2478

Mailing address

4901 Raleigh Common Dr Ste 100
Memphis, TN 38128-2478
Phone (901) 545-4331

Other names 1

  • My Clinic Memphis Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260402002576 TN Part B Supplier - Clinic/Group Practice 8628553070 Receives reassigned benefits from 1 practitioner
Practice locations: Memphis, TN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D2336267My Clinic Memphis4901 Raleigh Common Dr, Ste 110, Memphis, TN 38128Certificate of waiverDec 29, 2027

National Provider Directory

National Provider Directory

Locations

4901 Raleigh Common Dr
Ste 110
Memphis, TN 38128
Phone (901) 385-9586

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1747699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774137600000",
    "number": "1366234023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4901 RALEIGH COMMON DR STE 100",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381282478",
            "telephone_number": "901-545-4331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 RALEIGH COMMON DR STE 100",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381282478",
            "telephone_number": "901-545-4331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY CLINIC MEMPHIS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-20",
        "last_updated": "2026-03-22",
        "certification_date": "2026-03-22",
        "status": "A",
        "authorized_official_last_name": "REESE",
        "authorized_official_first_name": "ELISHEVA",
        "authorized_official_title_or_position": "FAMILY NURSE PRACTITIONER / OWNER",
        "authorized_official_telephone_number": "901-545-4331",
        "authorized_official_credential": "MSN, APRN, FNP-BC"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Research",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "My Clinic Memphis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.