Active NPI
Mary Kathryn Vescovo, FNP
- Nurse Practitioner
- Memphis, TN
National Provider Identifier
1851531164
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 14448
- Practice address
- 3362 S. Third Street
Christ Community Health Service Inc
Memphis, TN 38109 - Phone
- (901) 271-6300
- Fax
- (901) 260-8590
- NPI assigned
- Feb 26, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 14448 | TN | Primary |
Addresses
Primary practice location
3362 S. Third Street
Christ Community Health Service Inc
Memphis, TN 38109
Mailing address
2595 Central Avenue
Christ Community Health Services Inc
Memphis, TN 38104
Phone (901) 260-8500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1512954 | Medicaid | TN |
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14448 | TN | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1235606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1295481600000",
"number": "1851531164",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2595 CENTRAL AVENUE",
"address_2": "CHRIST COMMUNITY HEALTH SERVICES INC",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "38104",
"telephone_number": "901-260-8500",
"fax_number": "901-260-8590"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3362 S. THIRD STREET",
"address_2": "CHRIST COMMUNITY HEALTH SERVICE INC",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "38109",
"telephone_number": "901-271-6300",
"fax_number": "901-260-8590"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VESCOVO",
"first_name": "MARY",
"middle_name": "KATHRYN",
"name_prefix": "Ms.",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-02-26",
"last_updated": "2011-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "TN",
"license": "14448",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1512954",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.