| My Clinic Memphis | |
|
4901 Raleigh Common Dr Ste 100 Memphis TN 38128-2478 | |
| (901) 545-4331 | |
| Not Available |
| Full Name | My Clinic Memphis |
|---|---|
| Speciality | Clinic/Center |
| Location | 4901 Raleigh Common Dr Ste 100, Memphis, Tennessee |
| Authorized Official Name and Position | Elisheva Reese (FAMILY NURSE PRACTITIONER / OWNER) |
| Authorized Official Contact | 9015454331 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| My Clinic Memphis 4901 Raleigh Common Dr Ste 100 Memphis TN 38128-2478 Ph: (901) 545-4331 | My Clinic Memphis 4901 Raleigh Common Dr Ste 100 Memphis TN 38128-2478 Ph: (901) 545-4331 |
| NPI Number | 1366234023 |
|---|---|
| Provider Enumeration Date | 05/20/2025 |
| Last Update Date | 03/22/2026 |
| Certification Date | 03/22/2026 |
| Medicare PECOS PAC ID | 8628553070 |
|---|---|
| Medicare Enrollment ID | O20260402002576 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366234023 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (NU) | Primary |
| 261QR1100X | Clinic/center - Research | (NU) | Secondary |
| Provider Name | Elisheva Reese |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528422441 PECOS PAC ID: 0648569913 Enrollment ID: I20160510002409 |
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