Individual provider Active NPI

Marsha Dean, FNP

  • Nurse Practitioner
  • Germantown, TN
National Provider Identifier
1669412664
Registry record updated Dec 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APN5796 Issued in TN
Practice address
7600 Wolf River Blvd
Suite 220
Germantown, TN 38138-1785
Phone
(901) 755-5300
Fax
(901) 756-0196
NPI assigned
Jun 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2020

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 APN5796 TN Primary

Addresses

Primary practice location

7600 Wolf River Blvd
Suite 220
Germantown, TN 38138-1785

Mailing address

PO Box 2757
Cordova, TN 38088-2757
Phone (901) 755-5300

Other identifiers 2

IdentifierTypeStateIssuer
4068752OtherTNBLUE CROSS
02084773MedicaidMS

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
I20050923000791 TN Practitioner - Nurse Practitioner 6709810229 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN5796TNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-South Ear, Nose, and Throat, P.C. CurrentSince Nov 17, 2019 Accepting new patients
Mid-South Ear, Nose, and Throat, P.C. CurrentSince Apr 11, 2011 Accepting new patients
North Internal Medicine, P. C. PastSince Nov 9, 2020 Accepting new patients

Locations

7378 Yale Rd
Bartlett, TN 38133
Phone (901) 387-0193

8001 Centerview Pkwy
Ste 202
Cordova, TN 38018

7600 Wolf River Blvd
Ste 220
Germantown, TN 38138

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608163200000",
    "number": "1669412664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2757",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380882757",
            "telephone_number": "901-755-5300",
            "fax_number": "901-753-9659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 WOLF RIVER BLVD",
            "address_2": "SUITE 220",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381381785",
            "telephone_number": "901-755-5300",
            "fax_number": "901-756-0196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEAN",
        "first_name": "MARSHA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2020-12-17",
        "certification_date": "2020-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "APN5796",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "4068752",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02084773",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, TN

Sources for this page

Verify at the official NPI Registry.