Individual provider Active NPI

Mekeilah Nevaun Johnson, APRN, FNP-BC, FNP-C

  • Family Nurse Practitioner
  • Bartlett, TN
National Provider Identifier
1881247740
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26203 Issued in TN
Practice address
3082 Kirby Whitten Road
Bartlett, TN 38134
Phone
(901) 250-9080
NPI assigned
Jul 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

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 26203 TN Primary

Addresses

Primary practice location

3082 Kirby Whitten Road
Bartlett, TN 38134

Mailing address

PO Box 34834
Memphis, TN 38184-0834
Phone (901) 236-6564

Other practice location 1

6005 Park Ave Ste 825B
Memphis, TN 38119-5223
Phone (901) 250-9080

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
I20200129002584 TN Practitioner - Nurse Practitioner 3971939562 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fast Pace Medical Clinic PLLC 737 clinicians

Practice addresses (Care Compare)

100 E Tennessee St
Collinwood, TN 38450
Phone (931) 724-9000

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fast Pace Medical Clinic PLLC CurrentSince Nov 13, 2019 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Nov 13, 2019 Accepting new patients
Upperline Healthcare, PC CurrentSince Nov 1, 2025 Accepting new patients
Upperline Healthcare, PC CurrentSince Nov 1, 2025 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Dec 15, 2024 Accepting new patients

Locations

3082 Kirby Whitten Rd
Bartlett, TN 38134
Phone (901) 250-9080

7348 E Brainerd Rd
Chattanooga, TN 37421
Phone (205) 822-8038

108 Courtright Rd
Martin, TN 38237
Phone (731) 281-4183

Organizations & group practices 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1563494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1881247740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34834",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381840834",
            "telephone_number": "901-236-6564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3082 KIRBY WHITTEN ROAD",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "38134",
            "telephone_number": "901-250-9080"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6005 Park Ave Ste 825B",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381195223",
            "country_code": "US",
            "telephone_number": "901-250-9080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MEKEILAH",
        "middle_name": "NEVAUN",
        "credential": "APRN, FNP-BC, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-19",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "26203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bartlett, TN

Sources for this page

Verify at the official NPI Registry.