Individual provider Active NPI

Agnes Coughlin Fratta, FNP

  • Family Nurse Practitioner
  • Cordova, TN
National Provider Identifier
1780756924
Registry record updated May 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
12377 Issued in TN
Practice address
57 Germantown CT Ste 100
Cordova, TN 38018-4274
Phone
(901) 435-8550
Fax
(901) 478-0781
NPI assigned
Nov 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 12377 TN Primary

Addresses

Primary practice location

57 Germantown CT Ste 100
Cordova, TN 38018-4274

Mailing address

1211 Union Ave Ste 330
Memphis, TN 38104-6655

Other practice location 1

7460 Wolf River Blvd
Germantown, TN 38138-1760
Phone (901) 763-0200

Other practice location 2

4240 Bethel Rd Ste 201
Olive Branch, MS 38654-8737
Phone (901) 763-0200

Other identifiers 1

IdentifierTypeStateIssuer
12377OtherTNSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20070619000670 TN Practitioner - Nurse Practitioner 6608975495 Reassigns benefits to 1 organization
I20171122001304 MS Practitioner - Nurse Practitioner 6608975495 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Specialty Physician Group LLCGroup PAC ID 9537291323, 101 clinicians

Practice addresses (Care Compare)

4240 Bethel Rd
Suite 201
Olive Branch, MS 38654-8737
Phone (901) 763-0200

7460 Wolf River Blvd
Germantown, TN 38138-1760
Phone (901) 763-0200

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Specialty Physician Group LLC Family CurrentSince Oct 5, 2015 Accepting new patients
Lifestyle Neurology PC Past Accepting new patients
E Arthur Franklin MD PC Past Accepting new patients

Locations

4250 Bethel Rd
Fl 5
Olive Branch, MS 38654
Phone (662) 932-9544

4240 Bethel Rd
Ste 201
Olive Branch, MS 38654

57 Germantown Ct
Ste 100
Cordova, TN 38018
Phone (901) 435-8550

7460 Wolf River Blvd
#200
Germantown, TN 38138

1211 Union Ave
Ste 330
Memphis, TN 38104
Phone (901) 478-0954

7460 Wolf River Blvd
Memphis, TN 38138
Phone (901) 516-6792

Interoperability endpoints

  • Direct secure messaging: afratta22113@mlh.direct-ci.com

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777852800000",
    "number": "1780756924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 UNION AVE STE 330",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381046655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 GERMANTOWN CT STE 100",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380184274",
            "telephone_number": "901-435-8550",
            "fax_number": "901-478-0781"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7460 Wolf River Blvd",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "TN",
            "postal_code": "381381760",
            "country_code": "US",
            "telephone_number": "901-763-0200",
            "fax_number": "901-761-4002",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4240 Bethel Rd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Olive Branch",
            "state": "MS",
            "postal_code": "386548737",
            "country_code": "US",
            "telephone_number": "901-763-0200",
            "fax_number": "901-761-4002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRATTA",
        "first_name": "AGNES",
        "middle_name": "COUGHLIN",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2026-05-04",
        "certification_date": "2026-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "12377",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "12377",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cordova, TN

Sources for this page

Verify at the official NPI Registry.