Michelle Eubanks Boals, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

15713 Issued in TN

Practice address

262 Danny Thomas PL
Memphis, TN 38105-3678

Phone

(901) 595-3006

Fax

(901) 595-3842

NPI assigned

Apr 27, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Michelle Marie Eubanks Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1303862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348790400000",
    "number": "1801187687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "262 DANNY THOMAS PL",
            "address_2": "MS 515",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381053678",
            "telephone_number": "901-595-3006",
            "fax_number": "901-595-3842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "262 DANNY THOMAS PL",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381053678",
            "telephone_number": "901-595-3006",
            "fax_number": "901-595-3842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOALS",
        "first_name": "MICHELLE",
        "middle_name": "EUBANKS",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-27",
        "last_updated": "2012-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "15713",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1526106",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "EUBANKS",
            "middle_name": "MARIE",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Blythe Medical Services
• Joseph A Blythe, MD
• BMG Family Physicians Group Foundation, Inc
• Bmhsi/Ael Microbiology Laboratory, GP
• James W Boals Sr., MD
• Nino Boals, M.D.
• Deloise C Boatman, BS
• John Boatner, BA
• Lauren Eileen Bobal, B.A.
• Alexa Valeria Bobelis, ARNP

• Family Nurse Practitioner in Memphis, TN
• Providers in Memphis, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.