Reform Psychiatry LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

REFORM PSYCHIATRY LLC

Practice address

433 Nissan Dr Ste 301
Smyrna, TN 37167

Phone

(615) 751-0347

Fax

(615) 249-5162

NPI assigned

Apr 16, 2019

Last updated

Jul 1, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jemima Mensah, PMHNPNPI 1659834455

Title

Owner

Phone

(207) 530-0461

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Practitioners 1

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.

• Jemima Mensah, MSN, APRN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Smyrna, TN
  • NPI 1659834455
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1555372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561939200000",
    "number": "1417510363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "433 NISSAN DR STE 301",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371674360",
            "telephone_number": "615-751-0347",
            "fax_number": "615-249-5162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 NISSAN DR STE 301",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "37167",
            "telephone_number": "615-751-0347",
            "fax_number": "615-249-5162"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1925 Brookshine Prt",
            "address_purpose": "LOCATION",
            "city": "Antioch",
            "state": "TN",
            "postal_code": "370132958",
            "country_code": "US",
            "telephone_number": "615-768-1899",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "REFORM PSYCHIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-16",
        "last_updated": "2019-07-01",
        "status": "A",
        "authorized_official_last_name": "MENSAH",
        "authorized_official_first_name": "JEMIMA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-530-0461",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q049227",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Saritha Voncha Reddy, MD
• Kristal Nichole Reed, M.D.
• Leslie Reed, PTA
• Nicole Bernice Reeves
• Taylor Wayne Reeves, DDS
• Kathryn Reiker
• Reliable Medical Supply LLC
• Results-Ast JV, LLC
• Results-Ast JV, LLC
• Results-Ast JV, LLC

• Mental Health Clinic/Center (Including Community Mental Health Center) in Smyrna, TN
• Providers in Smyrna, TN by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2019; 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.