| Monogram Health Professional Services Pc | |
|
5410 Maryland Way Ste 301 Brentwood TN 37027-5064 | |
| (615) 673-4455 | |
| Not Available |
| Full Name | Monogram Health Professional Services Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 5410 Maryland Way Ste 301, Brentwood, Tennessee |
| Authorized Official Name and Position | Shawn Verner (GENERAL COUNSEL AND SECRETARY) |
| Authorized Official Contact | 6159941889 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Monogram Health Professional Services Pc 5410 Maryland Way Ste 301 Brentwood TN 37027-5064 Ph: (615) 673-4455 | Monogram Health Professional Services Pc 5410 Maryland Way Ste 301 Brentwood TN 37027-5064 Ph: (615) 673-4455 |
| NPI Number | 1326655986 |
|---|---|
| Provider Enumeration Date | 09/28/2020 |
| Last Update Date | 11/17/2022 |
| Medicare PECOS PAC ID | 4880004183 |
|---|---|
| Medicare Enrollment ID | O20210111001028 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326655986 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 207RN0300X | Internal Medicine - Nephrology | (* (Not Available)) | Primary |
| Provider Name | Joel Kavanagh |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1740391390 PECOS PAC ID: 7315098530 Enrollment ID: I20090630000188 |
| Provider Name | Donna R Watson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285866640 PECOS PAC ID: 5092846295 Enrollment ID: I20100702000434 |
| Provider Name | Nancy Jordan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659400885 PECOS PAC ID: 9537260351 Enrollment ID: I20101112000454 |
| Provider Name | Justin A Qualls |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669784930 PECOS PAC ID: 7113167107 Enrollment ID: I20130716000569 |
| Provider Name | Jacob R Whelan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023338183 PECOS PAC ID: 0244468544 Enrollment ID: I20140113001459 |
| Provider Name | Lisa H Terrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225447923 PECOS PAC ID: 4486978939 Enrollment ID: I20150112000437 |
| Provider Name | Hannah Poyner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295239218 PECOS PAC ID: 9032472535 Enrollment ID: I20180416001612 |
| Provider Name | Tammarin S Collins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184129306 PECOS PAC ID: 8820342280 Enrollment ID: I20181121001571 |
| Provider Name | Lakeshia Arrington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588121461 PECOS PAC ID: 4385987247 Enrollment ID: I20190515003175 |
| Provider Name | Judith Stallings |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902235583 PECOS PAC ID: 5698902138 Enrollment ID: I20200115001798 |
| Provider Name | Shaminder Gupta |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1730183401 PECOS PAC ID: 1658322300 Enrollment ID: I20210122000023 |
| Provider Name | Dantwan Shawntel Smith |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1659866895 PECOS PAC ID: 8729486477 Enrollment ID: I20220107000808 |
| Provider Name | Carrie Rebecca Hyde |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1114260726 PECOS PAC ID: 1658696307 Enrollment ID: I20220322000788 |
| Provider Name | Letoya Franklin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679930937 PECOS PAC ID: 5496050072 Enrollment ID: I20220519002516 |
| Provider Name | Venkatasubramanian Srinivasan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841273729 PECOS PAC ID: 8820078454 Enrollment ID: I20220624002690 |
| Provider Name | Samantha Yearwood |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1932850427 PECOS PAC ID: 4284000852 Enrollment ID: I20221116003135 |
| Provider Name | Jaclyn Masulli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124565171 PECOS PAC ID: 5294149761 Enrollment ID: I20221207000575 |
| Provider Name | Susan Bell |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1336285873 PECOS PAC ID: 7517122013 Enrollment ID: I20230130002201 |
| Provider Name | Zahily Fals |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1598078115 PECOS PAC ID: 6103121520 Enrollment ID: I20230823004197 |
| Provider Name | Amanda Bahler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245785013 PECOS PAC ID: 2860776481 Enrollment ID: I20231121002201 |
| Provider Name | Rick Michel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396079562 PECOS PAC ID: 3375938673 Enrollment ID: I20231204001368 |
| Provider Name | Katherine Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205101110 PECOS PAC ID: 1254594955 Enrollment ID: I20231206001487 |
| Provider Name | Jaydra Woods |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114319977 PECOS PAC ID: 5890014633 Enrollment ID: I20231206001923 |
| Provider Name | Lacey Lane Blessitt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972864148 PECOS PAC ID: 6800247909 Enrollment ID: I20240112000691 |
| Provider Name | Cambridge Odeasie Hendrix |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881376606 PECOS PAC ID: 8820440316 Enrollment ID: I20240119003711 |
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Monogram Health Professional Services Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5410 Maryland Way Ste 301, Brentwood, TN 37027 Phone: 615-673-4455 | |
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