Asparkle Inclusive Care
Organization Active NPI Psychiatric/Mental Health Nurse Practitioner · Cordova, TN
NPI 1679101190 · NPPES record last updated Feb 1, 2023
Key facts
- NPI
- 1679101190
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- Legal business name
- ASPARKLE INCLUSIVE CARE
- Practice address
- 8225 Rockcreek Pkwy
Cordova, TN 38016-4594 - Phone
- (901) 800-1037
- Fax
- (877) 669-2745
- NPI assigned
- Mar 30, 2020
- Organization subpart
- No
Authorized official
- Name
- Ms. Hortense K Bissila, APRN
- Title
- Pmhnp- Provider
- Phone
- (901) 800-1037
Practitioners 2
-
Josephine Nandzo, PMHNP-BC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in TN, AZ, AR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200811000961 | TN | Part B Supplier - Clinic/Group Practice | 7416372297 |
Receives reassigned benefits from 2 practitioners Practice locations: Cordova, TN |
| O20230210000284 | AZ | Part B Supplier - Clinic/Group Practice | 7416372297 |
Receives reassigned benefits from 1 practitioner Practice locations: Tempe, AZ |
| O20230612001427 | AR | Part B Supplier - Clinic/Group Practice | 7416372297 |
Receives reassigned benefits from 1 practitioner Practice locations: De Witt, AR |
National Provider Directory
Locations
1204 N Houston Levee Rd
Ste 115
Cordova, TN 38018
Phone (901) 800-1037
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner |
363LP0808X | Yes |
Addresses
Primary practice location
8225 Rockcreek Pkwy
Cordova, TN 38016-4594
Mailing address
1750 Lichfield CT
Cordova, TN 38016-3561
Phone (901) 800-1037
Other providers in Cordova, TN
- Ysabelle Charlaine Comia Arrozal
- Audra Arstikaitis-Nagel
- Jacqueline Yaa Konadu Asamoah
- Judy D Ash
- Chester Arthur Ashford Jr.
- Assure Senior Partners
- At Home Adult Day Care LLC
- At Home Physical Rehabilitation Group, LLC
- At Your Residence Health Care Services
- Athometherapy Solutions, PLLC
All providers in Cordova, TN · Psychiatric/Mental Health Nurse Practitioner in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 1, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.