Individual provider Active NPI

Mersha Wolde

  • Adult Psychiatric/Mental Health Registered Nurse
  • Murfreesboro, TN
National Provider Identifier
1780396655
Registry record updated Dec 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X
License
196007 Issued in TN
Practice address
3400 Lebanon Rd
Murfreesboro, TN 37129-1392
Phone
(615) 867-6000
NPI assigned
Dec 22, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Registered Nurse 163WP0809X 196007 TN Primary

Addresses

Primary practice location

3400 Lebanon Rd
Murfreesboro, TN 37129-1392

Mailing address

4009 George Buchanan Dr
La Vergne, TN 37086-3275

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
196007TNMDAdult Psychiatric/Mental Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1671667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671667200000",
    "number": "1780396655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4009 GEORGE BUCHANAN DR",
            "city": "LA VERGNE",
            "state": "TN",
            "postal_code": "370863275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 LEBANON RD",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371291392",
            "telephone_number": "615-867-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLDE",
        "first_name": "MERSHA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-22",
        "last_updated": "2022-12-22",
        "certification_date": "2022-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "TN",
            "license": "196007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murfreesboro, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.