| Elite Patient Care Of Tennessee Pllc | |
|
100 Peabody Pl Ste 150 Memphis TN 38103-3687 | |
| (337) 408-0797 | |
| Not Available |
| Full Name | Elite Patient Care Of Tennessee Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 100 Peabody Pl Ste 150, Memphis, Tennessee |
| Authorized Official Name and Position | Nicole Howard (SR VP OF ADMINISTRATIVE SERVICES) |
| Authorized Official Contact | 3374080797 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elite Patient Care Of Tennessee Pllc Po Box 108810 Oklahoma City OK 73101-8810 Ph: (337) 408-0797 | Elite Patient Care Of Tennessee Pllc 100 Peabody Pl Ste 150 Memphis TN 38103-3687 Ph: (337) 408-0797 |
| NPI Number | 1003575838 |
|---|---|
| Provider Enumeration Date | 12/09/2021 |
| Last Update Date | 10/02/2023 |
| Medicare PECOS PAC ID | 0042603656 |
|---|---|
| Medicare Enrollment ID | O20220203000451 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003575838 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
| Provider Name | Felesha R Perry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306262993 PECOS PAC ID: 7517187263 Enrollment ID: I20141001002087 |
| Provider Name | Stephanie Bell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770993412 PECOS PAC ID: 3476873480 Enrollment ID: I20160411001072 |
| Provider Name | Sherrika Evans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144681594 PECOS PAC ID: 1254639875 Enrollment ID: I20160415000742 |
| Provider Name | Melody Felts Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487135026 PECOS PAC ID: 4385079086 Enrollment ID: I20200126000038 |
| Provider Name | Kiwana Nicole Derrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871105320 PECOS PAC ID: 5294132478 Enrollment ID: I20210930003005 |
| Provider Name | Shenif Ladak |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1376948604 PECOS PAC ID: 5890018501 Enrollment ID: I20220204001818 |
| Provider Name | Sara Graves |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295324895 PECOS PAC ID: 0143625111 Enrollment ID: I20220404001782 |
| Provider Name | Vlastimil Smetka |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497974273 PECOS PAC ID: 1658424825 Enrollment ID: I20220412001824 |
| Provider Name | Dominique Pinilla |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124103965 PECOS PAC ID: 4880604446 Enrollment ID: I20230821000371 |
| Provider Name | Lisa Michelle Archer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821732488 PECOS PAC ID: 2567812720 Enrollment ID: I20231229001771 |
| Provider Name | Brian Cooper |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366678963 PECOS PAC ID: 0547426223 Enrollment ID: I20240213001039 |
| Provider Name | Ruth Seeley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295392421 PECOS PAC ID: 3779818737 Enrollment ID: I20240311000884 |
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