Individual provider Active NPI

Michelle Leah Mancell, FNP

  • Family Nurse Practitioner
  • Germantown, TN
National Provider Identifier
1629356118
Registry record updated Aug 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
15788 Issued in TN
Practice address
7514 Corporate Center Dr Ste 100
Germantown, TN 38138-3877
Phone
(901) 755-5333
Fax
(901) 757-9233
NPI assigned
Aug 1, 2011
Last updated
Aug 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 15788 TN Primary

Addresses

Primary practice location

7514 Corporate Center Dr Ste 100
Germantown, TN 38138-3877

Mailing address

1472 N Winding Wood Cir
Collierville, TN 38017-4093
Phone (901) 355-2066

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20230830001554 TN Practitioner - Nurse Practitioner 8123481736 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Consolidated Medical Practices of Memphis,PLLCGroup PAC ID 1759459845, 113 clinicians

Practice addresses (Care Compare)

6799 Great Oaks Rd
Suite 250
Memphis, TN 38138-2584
Phone (901) 261-0700

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15788TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Consolidated Medical Practices of Memphis,PLLC CurrentSince Aug 21, 2023 Accepting new patients
Professional Imaging of Tennessee PastSince Sep 5, 2023 Accepting new patients
LS of Memphis, PC Past Accepting new patients

Locations

6799 Great Oaks Rd
Ste 250
Memphis, TN 38138
Phone (901) 261-0700

7514 Corporate Center Dr
Ste 100
Memphis, TN 38138
Phone (901) 755-5333

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IBHBDD

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": "1312156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1629356118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1472 N WINDING WOOD CIR",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380174093",
            "telephone_number": "901-355-2066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7514 CORPORATE CENTER DR STE 100",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381383877",
            "telephone_number": "901-755-5333",
            "fax_number": "901-757-9233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANCELL",
        "first_name": "MICHELLE",
        "middle_name": "LEAH",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-01",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "15788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, TN

Sources for this page

Verify at the official NPI Registry.