Individual provider Active NPI

Alam Sharifi, DNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Covington, TN
National Provider Identifier
1669873774
Registry record updated Aug 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
19100 Issued in TN
Practice address
1997 Highway 51 S
Covington, TN 38019-3630
Phone
(901) 476-8967
NPI assigned
Sep 8, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2016

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 19100 TN
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 19100 TN Primary

Addresses

Primary practice location

1997 Highway 51 S
Covington, TN 38019-3630

Mailing address

1997 Highway 51 S
Covington, TN 38019-3630
Phone (901) 476-8967

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
I20150218000606 TN Practitioner - Nurse Practitioner 8224353123 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Professional Care Services of West TN, Inc.Group PAC ID 0042115537, 12 clinicians

Practice addresses (Care Compare)

1997 Hwy 51 S
Covington, TN 38019-3630
Phone (844) 727-2778

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19100TNMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Care Services of West TN, Inc. CurrentSince Nov 3, 2014 Accepting new patients
John J Harris MD PC CurrentSince Nov 1, 2017 Accepting new patients

Locations

1997 Highway 51 S
Covington, TN 38019
Phone (844) 727-2778

1661 International Dr
Ste 407
Memphis, TN 38120
Phone (901) 355-8075

5281 Navy Rd
Millington, TN 38053
Phone (901) 407-2944

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": "1410134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471478400000",
    "number": "1669873774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1997 HIGHWAY 51 S",
            "city": "COVINGTON",
            "state": "TN",
            "postal_code": "380193630",
            "telephone_number": "901-476-8967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1997 HIGHWAY 51 S",
            "city": "COVINGTON",
            "state": "TN",
            "postal_code": "380193630",
            "telephone_number": "901-476-8967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARIFI",
        "first_name": "ALAM",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-08",
        "last_updated": "2016-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "19100",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "19100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, TN

Sources for this page

Verify at the official NPI Registry.