Dongmo Georgette Tekobo

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APN0000030296 Issued in TN

Practice address

10710 Old Highway 64
Bolivar, TN 38008-3587

Phone

(731) 203-1011

Fax

(731) 658-1597

NPI assigned

Nov 3, 2021

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

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

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Step Up Care of Tennessee LLCGroup PAC ID 5395074728, 35 clinicians

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 and National Provider Directory roles.

• Step Up Care of Tennessee LLC

  • Psychologist
  • Memphis, TN
  • NPI 1023660206
  Medicare reassignment Care Compare group NPD
• Mental Health Centers & Clinics of Tennessee

  • Mental Health Counselor
  • Bolivar, TN
  • NPI 1255442794
  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Psychiatric/Mental Health, TN

  Medicare reassignment NPD
• Tri State Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Memphis, TN
  • NPI 1285002634
  Medicare reassignment

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

{
    "created_epoch": "1635897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698105600000",
    "number": "1821753906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3220 N AVENEL CV",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381250766",
            "telephone_number": "901-283-8280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10710 OLD HIGHWAY 64",
            "city": "BOLIVAR",
            "state": "TN",
            "postal_code": "380083587",
            "telephone_number": "731-203-1011",
            "fax_number": "731-658-1597"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3220 N Avenel Cv",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381250766",
            "country_code": "US",
            "telephone_number": "901-283-8280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GEORGETTE TEKOBO",
        "first_name": "DONGMO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-03",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "APN0000030296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Freds Stores of Tennessee Inc.
• Darvis Quinn Gallaher, PH. D.
• Holly Galloway, B.S.
• Rachel Elizabeth Garrity, M.S., CCC-SLP
• George W Walters Jr
• Mackenzie Culver German
• Marvin Gary Gill, M.ED.
• Rebecca L Grantham
• Eunice Gudger, BS
• Michelle Guia, BS

• Psychiatric/Mental Health Nurse Practitioner in Bolivar, TN
• Providers in Bolivar, 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 Oct 24, 2023; 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.