NPIMap

Individual provider Active NPI

Karen J Pease, FNP

  • Nurse Practitioner
  • Memphis, TN
National Provider Identifier
1619013638
Registry record updated Nov 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APN5482 Issued in TN
Practice address
650 New York St
Memphis, TN 38104-5536
Phone
(901) 728-5858
Fax
(901) 274-5858
NPI assigned
Jan 29, 2007
Last updated
Nov 28, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APN5482 TN Primary

Addresses

Primary practice location

650 New York St
Memphis, TN 38104-5536

Mailing address

650 New York St
Memphis, TN 38104-5536
Phone (901) 728-5858

Other identifiers 1

IdentifierTypeStateIssuer
3903047MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APN5482TNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Well Child Inc. Nurse Practitioner Past Accepting new patients

Organizations & group practices 7

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": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354060800000",
    "number": "1619013638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 NEW YORK ST",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381045536",
            "telephone_number": "901-728-5858",
            "fax_number": "901-274-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 NEW YORK ST",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381045536",
            "telephone_number": "901-728-5858",
            "fax_number": "901-274-5858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEASE",
        "first_name": "KAREN",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2012-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "APN5482",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3903047",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Nov 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.