Individual provider Active NPI

Brittany Mezquita, NP

  • Family Nurse Practitioner
  • Germantown, TN
National Provider Identifier
1710388020
Registry record updated Sep 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
24763 Issued in TN
Practice address
7945 Wolf River Blvd
Germantown, TN 38138
Phone
(901) 683-0055
Fax
(901) 685-2969
NPI assigned
Sep 6, 2014
Last updated
Sep 20, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 902836 MS
Family Nurse Practitioner 363LF0000X AP07819 LA
Family Nurse Practitioner 363LF0000X 24763 TN Primary

Addresses

Primary practice location

7945 Wolf River Blvd
Germantown, TN 38138

Mailing address

7714 Poplar Ave., Suite 200
Attention: Credentialing
Germantown, TN 38138-3941
Phone (901) 683-0055

Other practice location 1

7668 Airways Blvd
Southaven, MS 38671-5304
Phone (662) 349-9556

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
I20181204003279 TN Practitioner - Nurse Practitioner 2567786296

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
902836MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The West Clinic P.C. CurrentSince Aug 20, 2018 Accepting new patients

Locations

7668 Airways Blvd
Southaven, MS 38671
Phone (662) 349-9556

1588 Union Ave
Memphis, TN 38104
Phone (901) 276-2410

7714 Poplar Ave
Ste 200
Memphis, TN 38138
Phone (901) 322-9080

7945 Wolf River Blvd
Memphis, TN 38138
Phone (901) 448-7000

Organizations & group practices 1

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": "1409961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537401600000",
    "number": "1710388020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7714 POPLAR AVE., SUITE 200",
            "address_2": "ATTENTION: CREDENTIALING",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381383941",
            "telephone_number": "901-683-0055",
            "fax_number": "901-922-6722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7945 WOLF RIVER BLVD",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "38138",
            "telephone_number": "901-683-0055",
            "fax_number": "901-685-2969"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7668 Airways Blvd",
            "address_purpose": "LOCATION",
            "city": "Southaven",
            "state": "MS",
            "postal_code": "386715304",
            "country_code": "US",
            "telephone_number": "662-349-9556",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEZQUITA",
        "first_name": "BRITTANY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-06",
        "last_updated": "2018-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "902836",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP07819",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "24763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, TN

Sources for this page

Verify at the official NPI Registry.