| Core Psychiatry Inc. | |
|
1011 W Poplar Ave Ste 7 Collierville TN 38017-2577 | |
| (901) 446-0226 | |
| Not Available |
| Full Name | Core Psychiatry Inc. |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 1011 W Poplar Ave Ste 7, Collierville, Tennessee |
| Authorized Official Name and Position | Jason Eric Bruno (PRACTICE ADMINISTRATION) |
| Authorized Official Contact | 9014460226 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Core Psychiatry Inc. 1011 W Poplar Ave Ste 7 Collierville TN 38017-2577 Ph: (901) 446-0226 | Core Psychiatry Inc. 1011 W Poplar Ave Ste 7 Collierville TN 38017-2577 Ph: (901) 446-0226 |
| NPI Number | 1396344784 |
|---|---|
| Provider Enumeration Date | 10/18/2020 |
| Last Update Date | 01/13/2021 |
| Certification Date | 01/13/2021 |
| Medicare PECOS PAC ID | 7618381112 |
|---|---|
| Medicare Enrollment ID | O20210125000909 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396344784 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Primary |
| Provider Name | Katelyn Lee Conner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760902712 PECOS PAC ID: 2769756717 Enrollment ID: I20180109001004 |
| Provider Name | Christy Hamon Bruno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154836922 PECOS PAC ID: 9739438896 Enrollment ID: I20180822002285 |
| Provider Name | Ariel Scott Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700534310 PECOS PAC ID: 0042698920 Enrollment ID: I20220606000911 |
| Provider Name | Ross Jordan Tapley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447938139 PECOS PAC ID: 7315395233 Enrollment ID: I20231201002551 |
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