Individual provider Active NPI

Charonda Lynnice Phifer, FNP

  • Nurse Practitioner
  • Memphis, TN
National Provider Identifier
1922282573
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
20733 Issued in TN
Practice address
2430 Poplar Ave Ste 100
Memphis, TN 38112-3246
Phone
(866) 711-1717
Fax
(901) 339-6509
NPI assigned
Dec 18, 2007
Last updated
Jun 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 20733 TN Primary

Addresses

Primary practice location

2430 Poplar Ave Ste 100
Memphis, TN 38112-3246

Mailing address

4613 Jacob LN
Southaven, MS 38672-6408
Phone (310) 648-4343

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
I20160419000860 TN Practitioner - Nurse Practitioner 1355406992 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Tennessee, HSC, College of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Planned Parenthood Greater Memphis RegionGroup PAC ID 4284858671, 4 clinicians

Practice addresses (Care Compare)

2430 Poplar Ave
Memphis, TN 38112-3246

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17480CAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Planned Parenthood Greater Memphis Region CurrentSince Jan 29, 2016 Accepting new patients
Planned Parenthood Greater Memphis Region PastSince Jun 29, 2025 Accepting new patients

Locations

2430 Poplar Ave
#100
Memphis, TN 38112
Phone (901) 725-1717

2430 Poplar Ave
Ste 100
Memphis, TN 38112
Phone (901) 725-1717

Interoperability endpoints

  • Direct secure messaging: charonda.phiferrnp.p1@direct.plannedparenthoodla.nextgenshare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1197936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1922282573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4613 JACOB LN",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386726408",
            "telephone_number": "310-648-4343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2430 POPLAR AVE STE 100",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381123246",
            "telephone_number": "866-711-1717",
            "fax_number": "901-339-6509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHIFER",
        "first_name": "CHARONDA",
        "middle_name": "LYNNICE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-18",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "20733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.