| Care Memphis Clinic | |
|
493 Dr Ml King Jr Ave Memphis TN 38126-2548 | |
| (901) 526-0802 | |
| (901) 525-4483 |
| Full Name | Care Memphis Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 493 Dr Ml King Jr Ave, Memphis, Tennessee |
| Authorized Official Name and Position | Melissa B Foner (OWNER, PHYSICIAN ASSISTANT - CERTIF) |
| Authorized Official Contact | 9016524250 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Care Memphis Clinic 215 Buntyn St Memphis TN 38111-1609 Ph: (901) 652-4250 | Care Memphis Clinic 493 Dr Ml King Jr Ave Memphis TN 38126-2548 Ph: (901) 526-0802 |
| NPI Number | 1396192746 |
|---|---|
| Provider Enumeration Date | 05/16/2016 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 2860785052 |
|---|---|
| Medicare Enrollment ID | O20160726001527 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396192746 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 2811 (Tennessee) | Primary |
| Provider Name | Robert Ball |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063530871 PECOS PAC ID: 7214003888 Enrollment ID: I20080904000630 |
| Provider Name | Allyson B Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407115579 PECOS PAC ID: 0143485219 Enrollment ID: I20120625000067 |
| Provider Name | Kyrstyn N Mcneill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629572268 PECOS PAC ID: 0840555231 Enrollment ID: I20180606001847 |
| Provider Name | Lillian Funkhouser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174014948 PECOS PAC ID: 5890127997 Enrollment ID: I20191111002506 |
| Provider Name | Michelle Denise Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497388912 PECOS PAC ID: 4880004936 Enrollment ID: I20201102000882 |
| Provider Name | Tasha Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962155846 PECOS PAC ID: 9638562796 Enrollment ID: I20220214000304 |
| Provider Name | Trudy Dionne Tyler |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1235616921 PECOS PAC ID: 6507250636 Enrollment ID: I20220415000722 |
| Provider Name | Kiesha Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780262014 PECOS PAC ID: 7214306406 Enrollment ID: I20230109002687 |
| Provider Name | Portia Payne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578252276 PECOS PAC ID: 2769840263 Enrollment ID: I20230615000328 |
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