Lideaderick Lamar Gregory, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

40177 Issued in TN

Practice address

3030 Covington Pike Ste 200
Memphis, TN 38128-5048

Phone

(901) 266-8760

NPI assigned

Jan 9, 2024

Last updated

Aug 24, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

University of Alabama School of Medicine, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Medicos General PLLC

  dba Medicos Para La Familia

  • Family Medicine Physician
  • Memphis, TN
  • NPI 1952402885

  Psychiatric/Mental Health

  Medicare reassignment NPD

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

{
    "created_epoch": "1704758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787529600000",
    "number": "1720859762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 COVINGTON PIKE STE 200",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381285048",
            "telephone_number": "901-266-8760",
            "fax_number": "901-295-1375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 COVINGTON PIKE STE 200",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381285048",
            "telephone_number": "901-266-8760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREGORY",
        "first_name": "LIDEADERICK",
        "middle_name": "LAMAR",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-01-09",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "40177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiashi Greer, MD
• Gregory M. Turner (Gwendolyn Hills)
• Gregory T. Wilkinson DDS PC (Wilkinson Orthodontics and Children's Dentistry)
• Keon Monroe Gregory, MSN, APRN, FNP-BC
• Lela Gregory, LPC
• Patricia Jane Gregory
• Paul N. Gregory Jr., D.D.S., M.H.A.
• Stefanie Carol Gregory, P.T.
• Madeleine Amanda Gremillion, D.O.
• Flotyl K. Gresham, MSN, FNP-C

• Psychiatric/Mental Health Nurse Practitioner in Memphis, TN
• Providers in Memphis, TN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.