Individual provider Active NPI

Ingrid Marie Blay Cantrell

  • Physician Assistant
  • Memphis, TN
National Provider Identifier
1851573349
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1562 Issued in TN
Practice address
6401 Poplar Ave Ste 300
Memphis, TN 38119-4810
Phone
(800) 999-1249
Fax
(855) 656-7325
NPI assigned
Nov 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1562 TN Primary

Addresses

Primary practice location

6401 Poplar Ave Ste 300
Memphis, TN 38119-4810

Mailing address

9800 Shelbyville Rd Ste 220
Louisville, KY 40223-2992
Phone (305) 595-0109

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20080317000500 TN Practitioner - Physician Assistant 8527143478 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PSF PLLCGroup PAC ID 1557265543, 98 clinicians

Practice addresses (Care Compare)

464 N Pkwy
Suite D
Jackson, TN 38305-2810
Phone (731) 660-0138

6401 Poplar Ave
Suite 300
Memphis, TN 38119-4810
Phone (800) 999-1249

9755 US Hwy 64
Suite 101
Lakeland, TN 38002-8395
Phone (901) 587-5928

Merit-based Incentive Payment System (MIPS)

Final score
84.25 of 100Reported as group
Quality
86.03
Promoting interoperability
86
Improvement activities
40
Cost
73.15

Merit-based Incentive Payment System (MIPS)

Final score
75.09 of 100Reported as group
Quality
50.47
Promoting interoperability
99
Improvement activities
40
Cost
67.33

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1562TNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-South Dermatology, PC Past Accepting new patients
Saint Francis Physician Network, LLC PastSince Feb 26, 2019 Accepting new patients
CC Bpci PLC Past Accepting new patients

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1196121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1851573349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9800 SHELBYVILLE RD STE 220",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402232992",
            "telephone_number": "305-595-0109",
            "fax_number": "855-656-7325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6401 POPLAR AVE STE 300",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381194810",
            "telephone_number": "800-999-1249",
            "fax_number": "855-656-7325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAY CANTRELL",
        "first_name": "INGRID",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-27",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "1562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.