Individual provider Active NPI

Bisrat Micael Mengistu, FNP-C

  • Family Nurse Practitioner
  • Mount Juliet, TN
National Provider Identifier
1508631599
Registry record updated May 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
35261 Issued in TN
Practice address
401 S Mount Juliet Rd
Mount Juliet, TN 37122-6359
Phone
(615) 758-1524
NPI assigned
Nov 20, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4028983 KY
Family Nurse Practitioner 363LF0000X 35261 TN Primary

Addresses

Primary practice location

401 S Mount Juliet Rd
Mount Juliet, TN 37122-6359

Mailing address

401 S Mount Juliet Rd
Mt Juliet, TN 37122-6359
Phone (615) 758-1524

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, KY2 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
I20240320002712 TN Practitioner - Nurse Practitioner 2264879626 Reassigns benefits to 1 organization
I20250303002498 KY Practitioner - Nurse Practitioner 2264879626 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Little Clinic of Tennessee LLCGroup PAC ID 4688762800, 132 clinicians

Practice addresses (Care Compare)

2011 Nashville Pike
Gallatin, TN 37066-3162
Phone (615) 575-1130

210 Franklin Rd
Suite 100
Brentwood, TN 37027-3218
Phone (615) 393-6550

3054 Columbia Ave
Franklin, TN 37064-7424
Phone (615) 550-0091

401 S Mount Juliet Rd
Mount Juliet, TN 37122-6359
Phone (615) 758-1524

463 Sam Ridley Pkwy W
Smyrna, TN 37167-5626
Phone (615) 768-4258

6690 Nolensville Rd
Brentwood, TN 37027-8803
Phone (615) 941-7670

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kiosk Medicine Kentucky LLC Family CurrentSince Feb 20, 2025 Accepting new patients
The Little Clinic of Tennessee LLC Family CurrentSince Feb 13, 2024 Accepting new patients

Locations

2945 Scottsville Rd
Ste E32
Bowling Green, KY 42104
Phone (270) 783-3992

3039 Breckenridge Ln
Louisville, KY 40220
Phone (502) 451-4555

5544 Old Hickory Blvd
Hermitage, TN 37076
Phone (615) 515-0029

401 S Mount Juliet Rd
Mt Juliet, TN 37122
Phone (615) 393-1709

2449 Old Fort Pkwy
Murfreesboro, TN 37128
Phone (615) 225-0140

Interoperability endpoints

  • Direct secure messaging: bisrat.mengistu@krogerhealth.eclinicaldirectplus.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1700438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747180800000",
    "number": "1508631599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 S MOUNT JULIET RD",
            "city": "MT JULIET",
            "state": "TN",
            "postal_code": "371226359",
            "telephone_number": "615-758-1524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 S MOUNT JULIET RD",
            "city": "MOUNT JULIET",
            "state": "TN",
            "postal_code": "371226359",
            "telephone_number": "615-758-1524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENGISTU",
        "first_name": "BISRAT",
        "middle_name": "MICAEL",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-20",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "4028983",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "35261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Juliet, TN

Sources for this page

Verify at the official NPI Registry.