| Tri State Community Health Center | |
|
4041 Knight Arnold Rd Suite 100 Memphis TN 38118-2128 | |
| (901) 360-0442 | |
| (901) 360-0865 |
| Full Name | Tri State Community Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 4041 Knight Arnold Rd, Memphis, Tennessee |
| Authorized Official Name and Position | Albert L Richardson (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 9013600442 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tri State Community Health Center 4041 Knight Arnold Rd Suite 100 Memphis TN 38118-2128 Ph: (901) 360-0442 | Tri State Community Health Center 4041 Knight Arnold Rd Suite 100 Memphis TN 38118-2128 Ph: (901) 360-0442 |
| NPI Number | 1285002634 |
|---|---|
| Provider Enumeration Date | 09/02/2015 |
| Last Update Date | 03/26/2024 |
| Medicare PECOS PAC ID | 4486955341 |
|---|---|
| Medicare Enrollment ID | O20151217001928 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285002634 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Primary |
| Provider Name | Trevina H Springer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669449484 PECOS PAC ID: 3971530593 Enrollment ID: I20050725001095 |
| Provider Name | Jeffrey H Lowrey |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1154314755 PECOS PAC ID: 4688641285 Enrollment ID: I20080625000532 |
| Provider Name | Iverson C Bell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073529046 PECOS PAC ID: 9739105628 Enrollment ID: I20101229000526 |
| Provider Name | Monica L Warhaftig |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235244450 PECOS PAC ID: 5799686739 Enrollment ID: I20110721000844 |
| Provider Name | Martha J Hayes-hudspeth |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942526645 PECOS PAC ID: 4385619766 Enrollment ID: I20121116000047 |
| Provider Name | Pauline L Adhoch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467790469 PECOS PAC ID: 5193960276 Enrollment ID: I20130320000204 |
| Provider Name | Roberto Levi-d'ancona |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1053394155 PECOS PAC ID: 7416850730 Enrollment ID: I20150424000231 |
| Provider Name | Pallavi Khanna |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1598161838 PECOS PAC ID: 3173832177 Enrollment ID: I20151013002310 |
| Provider Name | Camille Tabor-cobb |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1609101740 PECOS PAC ID: 3274811401 Enrollment ID: I20161024000426 |
| Provider Name | Brittany S Moten |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154771541 PECOS PAC ID: 8426338278 Enrollment ID: I20161213001571 |
| Provider Name | Ramona Phinehas |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1477993665 PECOS PAC ID: 9436427929 Enrollment ID: I20170626001820 |
| Provider Name | Marina Santa Cruz Terrazas |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1457790610 PECOS PAC ID: 3577835057 Enrollment ID: I20170817002821 |
| Provider Name | Matthew Carraway |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1003222761 PECOS PAC ID: 8628340973 Enrollment ID: I20170821002432 |
| Provider Name | Adrienne A Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487199881 PECOS PAC ID: 5496002818 Enrollment ID: I20180717001718 |
| Provider Name | Lillian Landrigan |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1720135874 PECOS PAC ID: 6406103431 Enrollment ID: I20180723002581 |
| Provider Name | Bridgette Jone Torrance-williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366954232 PECOS PAC ID: 2961759527 Enrollment ID: I20181015000044 |
| Provider Name | Chanel Alleise Townsend |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932663002 PECOS PAC ID: 6507106887 Enrollment ID: I20190325000189 |
| Provider Name | Nicholas Cornell Brooks |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1326404963 PECOS PAC ID: 4981907789 Enrollment ID: I20190520001997 |
| Provider Name | Jasmine Powell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740806991 PECOS PAC ID: 8224442769 Enrollment ID: I20210125002495 |
| Provider Name | Kimberly D Patterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952972606 PECOS PAC ID: 8820495930 Enrollment ID: I20210915004025 |
| Provider Name | Tamario Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609445923 PECOS PAC ID: 0941682611 Enrollment ID: I20220728001271 |
| Provider Name | Monique Morriette Watson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063091205 PECOS PAC ID: 3375911134 Enrollment ID: I20221129000746 |
| Provider Name | Dominique Coley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700424025 PECOS PAC ID: 8325461353 Enrollment ID: I20230209000242 |
| Provider Name | Kelsey Ray Bastian |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710546213 PECOS PAC ID: 8921460247 Enrollment ID: I20230817001787 |
| Provider Name | Ashley Lucas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326700949 PECOS PAC ID: 5890142186 Enrollment ID: I20231108000594 |
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