Individual provider Active NPI

Stephanie Ham

  • Family Nurse Practitioner
  • Germantown, TN
National Provider Identifier
1861001794
Registry record updated Jul 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
27904 Issued in TN
Practice address
7945 Wolf River Blvd
Germantown, TN 38138-1762
Phone
(901) 683-0055
Fax
(901) 685-9718
NPI assigned
Jul 27, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2020

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 27904 TN Primary

Addresses

Primary practice location

7945 Wolf River Blvd
Germantown, TN 38138-1762

Mailing address

7945 Wolf River Blvd
Germantown, TN 38138-1762
Phone (901) 683-0055

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sham@westclinic.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS, AR3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20200910001470 TN Practitioner - Nurse Practitioner 4880012673 Reassigns benefits to 2 organizations
I20201116001288 MS Practitioner - Nurse Practitioner 4880012673 Reassigns benefits to 1 organization
I20240905001360 AR Practitioner - Nurse Practitioner 4880012673 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cancer Care Associates IncGroup PAC ID 2769637222, 23 clinicians
The West Clinic P.C.Group PAC ID 2668360579, 115 clinicians

Practice addresses (Care Compare)

225 E Jackson Ave
Jonesboro, AR 72401-3119
Phone (870) 207-8210

7668 Airways Blvd
Southaven, MS 38671-5304
Phone (662) 349-9556

7945 Wolf River Blvd
Germantown, TN 38138-1762
Phone (901) 683-0055

Merit-based Incentive Payment System (MIPS)

Final score
90.15 of 100Reported as subgroup
Quality
83.22
Promoting interoperability
100
Improvement activities
40
Cost
77.26

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Shelby County Health Care Corporation CurrentSince Nov 1, 2020 Accepting new patients
The West Clinic P.C. CurrentSince Aug 3, 2020 Accepting new patients
Cancer Care Associates Inc CurrentSince Aug 12, 2024 Accepting new patients
Shelby County Health Care Corporation CurrentSince Nov 1, 2020 Accepting new patients
The West Clinic P.C. CurrentSince Aug 3, 2020 Accepting new patients
Allara Medical Group PA Past Accepting new patients

Locations

225 E Jackson Ave
Jonesboro, AR 72401
Phone (870) 207-1630

7668 Airways Blvd
Southaven, MS 38671
Phone (662) 349-9556

240 Grandview Dr
Brighton, TN 38011
Phone (901) 475-0678

7714 Poplar Ave
Ste 200
Memphis, TN 38138
Phone (901) 322-9080

7945 Wolf River Blvd
Memphis, TN 38138
Phone (901) 448-7000

1588 Union Ave
Memphis, TN 38104
Phone (901) 276-2410

877 Jefferson Ave
Memphis, TN 38103
Phone (901) 448-5893

1290 Kelley Dr
Paris, TN 38242
Phone (270) 554-0011

Interoperability endpoints

  • Direct secure messaging: sham32997@mlh.direct-ci.com

Organizations & group practices 6

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": "1595808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595808000000",
    "number": "1861001794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7945 WOLF RIVER BLVD",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381381762",
            "telephone_number": "901-683-0055",
            "fax_number": "901-685-9718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7945 WOLF RIVER BLVD",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381381762",
            "telephone_number": "901-683-0055",
            "fax_number": "901-685-9718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAM",
        "first_name": "STEPHANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-27",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "27904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sham@westclinic.com",
            "affiliation": "N",
            "address_1": "7945 Wolf River Blvd",
            "city": "Germantown",
            "state": "TN",
            "country_code": "US",
            "postal_code": "381381762",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Germantown, TN

Sources for this page

Verify at the official NPI Registry.