Individual provider Active NPI

Phyllis Thompson, DNP FNP-C

  • Nurse Practitioner
  • Memphis, TN
National Provider Identifier
1952808651
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APN0000024375 Issued in TN
Practice address
806 S Cooper St
Memphis, TN 38104-5406
Phone
(901) 896-0739
Fax
(833) 695-8358
NPI assigned
Apr 9, 2018
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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 905231 MS
Nurse Practitioner 363L00000X A005681 AR
Nurse Practitioner 363L00000X APN0000024375 TN Primary

Addresses

Primary practice location

806 S Cooper St
Memphis, TN 38104-5406

Mailing address

806 S Cooper St
Memphis, TN 38104-5406
Phone (901) 896-0739

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20190313002821 AR Practitioner - Nurse Practitioner 5597005397 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A005681ARMDNurse Practitioner
905231MSMDNurse Practitioner
APN0000024375TNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates, PLLC Nurse Practitioner CurrentSince May 24, 2024 Accepting new patients
Priority Health and Consultant LLC Nurse Practitioner Current Accepting new patients

Locations

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • Direct secure messaging: phyllis.thompson.1@17956.direct.athenahealth.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1523232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1952808651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 S COOPER ST",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381045406",
            "telephone_number": "901-896-0739",
            "fax_number": "833-695-8358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 S COOPER ST",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381045406",
            "telephone_number": "901-896-0739",
            "fax_number": "833-695-8358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "PHYLLIS",
        "name_prefix": "Dr.",
        "credential": "DNP  FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-09",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "905231",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AR",
            "license": "A005681",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "APN0000024375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.