Individual provider Active NPI

Carmen Johnson, FNP-C

  • Family Nurse Practitioner
  • Collierville, TN
National Provider Identifier
1881572550
Registry record updated Aug 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
39465 Issued in TN
Practice address
526 Halle Park Dr
Collierville, TN 38017-7085
Phone
(901) 261-0700
NPI assigned
Aug 21, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2025

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 39465 TN Primary

Addresses

Primary practice location

526 Halle Park Dr
Collierville, TN 38017-7085

Mailing address

5463 Pine Oak LN
Bartlett, TN 38135-8264
Phone (270) 519-5883

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
I20250922001225 TN Practitioner - Nurse Practitioner 4880198811 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Guidestar Eldercare - TN, PCGroup PAC ID 8527413517, 20 clinicians

Practice addresses (Care Compare)

6000 Poplar Ave
Suite 250
Memphis, TN 38119-3974
Phone (574) 546-1900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Guidestar Eldercare - TN, P.C. Family CurrentSince Nov 1, 2025 Accepting new patients
Consolidated Medical Practices of Memphis,PLLC CurrentSince Oct 1, 2025 Accepting new patients

Locations

526 Halle Park Dr
Collierville, TN 38017
Phone (901) 730-5345

6799 Great Oaks Rd
Ste 250
Memphis, TN 38138
Phone (901) 261-0700

6000 Poplar Ave
Ste 250
Memphis, TN 38119
Phone (901) 451-9577

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IBHBDD

Organizations & group practices 2

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": "1755734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1881572550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5463 PINE OAK LN",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381358264",
            "telephone_number": "270-519-5883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "526 HALLE PARK DR",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380177085",
            "telephone_number": "901-261-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CARMEN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-21",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "39465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Collierville, TN

Sources for this page

Verify at the official NPI Registry.