KELLY A MUNDY (NPI# 1427228816) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427228816 |
| Entity Type | Individual |
| Full Name | KELLY A MUNDY |
| Other Name | KELLY ANN ZIMMERMAN |
| Credential | FNP, RNFA |
| Practice Address |
6286 Briarcrest Ave Ste 200 Memphis TN 38120-4023 |
| Mailing Address |
6077 Primacy Pkwy Ste 140 Memphis TN 38119-5742 |
| Practice Telephone | 9016413000 |
| Practice Fax Number | 9012591698 |
| Mailing Telephone | 9017258347 |
| Mailing Fax Number | 9012597637 |
| Enumeration Date | 2008-03-03 |
| Last Update Date | 2019-06-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 192906 | TN | Nursing Service Providers |
| N | 363L00000X | Nurse Practitioner | AOO5005 | AR | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363L00000X | Nurse Practitioner | 901950 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363L00000X | Nurse Practitioner | 17474 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | BWC | 1073920 | 01 |
| OH | UNISON | 000000246172 | 01 |
| WV | RAILROAD MEDICARE | P00749322 | 01 |
| OH | MOLINA | 2852999 | 01 |
| OH | 2852999 | 05 | |
| WV | 3810012886 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 7580 Clarington Cv, Southaven, MS 386715657 | 9016413000 | 9012591698 |
| Street Address |
6286 BRIARCREST AVE STE 200 |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38120-4023 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700889730 | Kenneth S Weiss | Orthopaedic Surgery | 6286 Briarcrest Ave Ste 200, Memphis, TN 38120-4023 | 2005-05-23 |
| 1578197919 | Emma Virginia Cotton | Physician Assistant | 6286 Briarcrest Ave Ste 200, Memphis, TN 38120-4023 | 2020-02-25 |
| 1295395333 | Maria Moore | Physician Assistant | 6286 Briarcrest Ave Ste 200, Memphis, TN 38120-4023 | 2019-06-20 |
| 1861960312 | Kori Taylor | Occupational Therapist | 6286 Briarcrest Ave Ste 200, Memphis, TN 38120-4023 | 2018-11-02 |
| 1851805550 | David James Caswell | Physical Therapy Assistant | 6286 Briarcrest Ave Ste 200, Memphis, TN 38120-4023 | 2017-11-17 |
| 1407391055 | Jessica Bradshaw | Physician Assistant | 6286 Briarcrest Ave Ste 200, Memphis, TN 38120-4023 | 2017-01-05 |
| 1326592015 | Sarah Elizabeth Hill | Physician Assistant | 6286 Briarcrest Ave Ste 200, Memphis, TN 38120-4023 | 2016-08-10 |
| 1396194122 | Leslie Frazier | Physician Assistant | 6286 Briarcrest Ave Ste 200, Memphis, TN 38120-4023 | 2016-06-13 |
| 1689040271 | Sarah Anne Hammond | Physician Assistant | 6286 Briarcrest Ave Ste 200, Memphis, TN 38120-4023 | 2015-08-18 |
| 1457770588 | William Austin Hester IIi | Orthopaedic Surgery | 6286 Briarcrest Ave Ste 200, Memphis, TN 38120-4023 | 2014-04-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093285637 | Cobblestone Midwifery | Midwife | 5617 Ashley Square South, Memphis, TN 38120 | 2018-11-27 |
| 1649768870 | River City Neuropsychology, Pllc | Psychologist | 1661 International Dr., Suite 400, Memphis, TN 38120 | 2018-04-24 |
| 1841676152 | Jody Lavaun Clements | Dentist | 795 Ridge Lake Blvd Ste 101, Memphis, TN 38120 | 2015-08-10 |
| 1578957122 | Christina Lumpkin | Nurse Practitioner | 6305 Humphreys Blvd Ste 101, Memphis, TN 38120 | 2015-03-21 |
| 1316352099 | Daniel Poor | Emergency Medicine | Baptist Memorial Hospital Memphis, 124 N. Humphrey's Blvd, Memphis, TN 38120 | 2014-06-21 |
| 1245643246 | Kysha Saleem | Nurse Practitioner | 6027 Walnut Grove Rd., Suite 312, Memphis, TN 38120 | 2014-06-06 |
| 1376962613 | John Christopher Swearingen | Dentist | 780 Ridge Lake Blvd Ste 101, Memphis, TN 38120 | 2014-04-15 |
| 1275884645 | Rebecca Leigh Goedecke | Nurse Practitioner | 6215 Humphreys Blvd Ste 301, Memphis, TN 38120 | 2012-09-26 |
| 1730475179 | Sarah Elizabeth Hammond | Surgery | Plastic Surgery Group, 80 Humphreys Blvd #100, Memphis, TN 38120 | 2011-06-23 |
| 1922302785 | Daniel L Hester | Nurse Anesthetist, Certified Registered | 1755 Kirby Parkway Suite 330, Memphis, TN 38120 | 2011-01-07 |
| Find all providers in zip 38120 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982204038 | Ann Clare Guest | Nurse Practitioner | 1483 Goodbar Ave, Memphis, TN 38104-4912 | 2020-10-28 |
| 1154936946 | Allyson Escott Dormois | Nurse Practitioner | 130 Flicker St, Memphis, TN 38104-5928 | 2020-09-09 |
| 1831702224 | Tennessee In-home Partner-iv, LLC | Nurse Practitioner | Sumner Medical Plaza, 300 Steam Plant Road, Suite 220, Memphis, TN 37066-3032 | 2020-08-26 |
| 1881160059 | Christopher Paul Hernandez | Nurse Practitioner | 877 Jeffeon Ave, Memphis, TN 38103 | 2018-10-15 |
| 1326544800 | Kimberly Vestoria Mcclinton | Nurse Practitioner | 2200 Union Ave 1, Memphis, TN 38104 | 2018-04-03 |
| 1780199786 | Shkendie Papraniku | Nurse Practitioner | 6005 Park Ave Ste 510, Memphis, TN 38119-5215 | 2017-12-12 |
| 1063926079 | Megan Lee Alexander | Nurse Practitioner | 877 Jefferson Ave Fl 2, Memphis, TN 38103-2807 | 2017-11-29 |
| 1427568260 | Miranda D White | Nurse Practitioner | 6027 Walnut Grove Rd Ste 114, Memphis, TN 38120-2115 | 2017-10-06 |
| 1184098956 | Mika Tralayne Jackson | Nurse Practitioner | 4075 S Lakewood Dr, Memphis, TN 38128-4401 | 2015-11-17 |
| 1184009649 | Linda Fay Williams | Nurse Practitioner | 3655 Haughton Lane #2, Memphis, TN 38128 | 2015-07-27 |
| Find all providers in MEMPHIS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.