Individual provider Active NPI

Shelia K Thomas, RN, APN

  • Family Nurse Practitioner
  • Memphis, TN
National Provider Identifier
1992999791
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
12753 Issued in TN
Practice address
6266 Poplar Ave
Memphis, TN 38119-4713
Phone
(901) 682-2595
Fax
(901) 682-2549
NPI assigned
Sep 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 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 12753 TN Primary

Addresses

Primary practice location

6266 Poplar Ave
Memphis, TN 38119-4713

Mailing address

6266 Poplar Ave
Memphis, TN 38119-4713
Phone (901) 682-2595

Other identifiers 1

IdentifierTypeStateIssuer
1525666MedicaidTN

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
I20110928000849 TN Practitioner - Nurse Practitioner 1254502982 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12753TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-South Maternal Fetal Medicine PC CurrentSince Aug 23, 2011 Accepting new patients
Southwind Endoscopy Center Past Accepting new patients

Locations

6266 Poplar Ave
Memphis, TN 38119
Phone (901) 682-2595

Interoperability endpoints

  • Direct secure messaging: sthomas33598@mlh.direct-ci.com
  • Direct secure messaging: sthomas@mmfm.directglo.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": "1188950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1992999791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6266 POPLAR AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381194713",
            "telephone_number": "901-682-2595",
            "fax_number": "901-682-2549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6266 POPLAR AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381194713",
            "telephone_number": "901-682-2595",
            "fax_number": "901-682-2549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "SHELIA",
        "middle_name": "K",
        "credential": "RN, APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-05",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "12753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1525666",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.