Individual provider Active NPI

Paula Rene Gugert, DNP

  • Acute Care Nurse Practitioner
  • Cordova, TN
National Provider Identifier
1407625338
Registry record updated Dec 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
874413 Issued in MS
Practice address
300 S Walnut Bend Rd Ste 12
Cordova, TN 38018-7527
Phone
(901) 767-0101
NPI assigned
Dec 20, 2023
Last updated
Dec 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 35377 TN
Acute Care Nurse Practitioner 363LA2100X 874413 MS Primary

Addresses

Primary practice location

300 S Walnut Bend Rd Ste 12
Cordova, TN 38018-7527

Mailing address

7105 Swinnea Rd Ste 1
Southaven, MS 38671-6012
Phone (901) 767-0101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240205002444 TN Practitioner - Nurse Practitioner 3476996687 Reassigns benefits to 1 organization
I20240212003125 MS Practitioner - Nurse Practitioner 3476996687 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mittal Kidney and Dialysis, PCGroup PAC ID 9830152958, 6 clinicians

Practice addresses (Care Compare)

300 S Walnut Bend Rd
Suite 12
Cordova, TN 38018-7527
Phone (901) 767-0101

7620 Clarington Cove
Southaven, MS 38671-4739
Phone (901) 767-0101

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
874413MSMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mittal Kidney and Dialysis PC CurrentSince Feb 1, 2024 Accepting new patients
Mittal Kidney and Dialysis PastSince Dec 24, 2023 Accepting new patients
Memphis Neurology PLLC PastSince Aug 1, 2021 Accepting new patients

Locations

7684 Airways Blvd
Southaven, MS 38671
Phone (901) 405-0275

7620 Clarington Cv
Southaven, MS 38671
Phone (901) 767-0101

7105 Swinnea Rd
Ste 1
Southaven, MS 38671

300 S Walnut Bend Rd
Ste 12
Cordova, TN 38018
Phone (901) 767-0101

Interoperability endpoints

  • Direct secure messaging: pgugert67897@mlh.direct-ci.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/GCFDAA
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.73850

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1703030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1407625338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7105 SWINNEA RD STE 1",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386716012",
            "telephone_number": "901-767-0101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S WALNUT BEND RD STE 12",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380187527",
            "telephone_number": "901-767-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUGERT",
        "first_name": "PAULA",
        "middle_name": "RENE",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-20",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TN",
            "license": "35377",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MS",
            "license": "874413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cordova, TN

Sources for this page

Verify at the official NPI Registry.