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PASSPORT HEALTH
NPI 1366797276
Nurse Practitioner in Memphis, TN

Active since July 17, 2012CLIA 44D2035531 · Waiver
4515 POPLAR AVE, STE 507, MEMPHIS, TN 38117(901) 681-2700 Get Directions Write a Review

NPPES record last updated: July 23, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Passport Health NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PASSPORT HEALTH (NPI 1366797276) is a healthcare organization registered as a nurse practitioner in Memphis, Tennessee and active in the NPI registry since July 2012. The organization holds a CLIA Waiver certificate valid through January 18, 2028 and lists Tonya Parson, Ceo, as its authorized official.

NPPES Registry Identity

NPI1366797276
Entity TypeOrganization
Primary Taxonomy363L00000X
Legal Business NamePPH MEDICAL OF TN, INC DBA
Location Address4515 POPLAR AVE, STE 507Memphis, TN 38117-7503
Mailing Address4515 Poplar Ave, Suite 131Memphis, TN 38117 · (901) 681-2700 · Fax (901) 681-2702
Phone(901) 681-2700
Organization SubpartNo
Authorized OfficialTonya ParsonCeo · (901) 681-2700
Enumeration DateJuly 17, 2012
Last NPPES UpdateJuly 23, 2015
✔ NPI 1366797276 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
Definition
(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.
4515 POPLAR AVE, Memphis, TN 38117
Open in Google Maps ↗

Other Names 1

Doing Business AsPassport Health

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 44D2035531

Passport Health · Memphis, TN
Active · expires Jan 18, 2028
CLIA Number44D2035531
Laboratory TypeMobile Laboratory
Certificate Effective DateJanuary 19, 2026
Certificate Expiration DateJanuary 18, 2028
Laboratory DirectorTonya Parson
Laboratory Phone(901) 681-2700
Laboratory LocationPassport Health4515 Poplar Ave, Suite 131, Memphis, TN 38117
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. WILLIAM E LLOYD DDS
Dentist (General Practice)
4515 POPLAR AVE, #225
MEMPHIS, TN 38117
Shelby County (901) 761-4647
DR. MIHAELA LEORDEANU D.D.S.
Dentist (General Practice)
4515 POPLAR AVE, STE. 227
MEMPHIS, TN 38117
Shelby County (901) 680-9578
WALLACE WYMON DYKE DDS
Dentist (General Practice)
4515 POPLAR AVE, STE. 406
MEMPHIS, TN 38117
Shelby County (901) 683-9800
MRS. MARY R DEAN LPC MHSP
Counselor (Professional)
4515 POPLAR AVE, SUITE 515
MEMPHIS, TN 38117
Shelby County (901) 763-1288
DR. CHARLES ZEL PLESOFSKY DDS
Dentist (General Practice)
4515 POPLAR AVE, SUITE 300
MEMPHIS, TN 38117
Shelby County (901) 682-3311
DR. JOHN W MCCOY PHD
Psychologist (Clinical)
4515 POPLAR AVE
MEMPHIS, TN 38117
Shelby County (901) 756-5583
HANNAH GRAYCE CREASEY LCSW, MPH
Counselor
4515 POPLAR AVE
MEMPHIS, TN 38117
Shelby County (901) 654-5551
MRS. SHEILA C VAMPLIN L.M.F.T.
Marriage & Family Therapist
4515 POPLAR AVE, SUITE 422
MEMPHIS, TN 38117
Shelby County (901) 537-2900

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pph Medical Of Tn, Inc Dba's NPI number?

The NPI number for Pph Medical Of Tn, Inc Dba is 1366797276. It was assigned to this organization in the NPPES registry on July 17, 2012. The provider is doing business as Passport Health.

Where is Pph Medical Of Tn, Inc Dba located?

Pph Medical Of Tn, Inc Dba is located at 4515 Poplar Ave Ste 507, Memphis, TN 38117. The listed phone number is (901) 681-2700.

What is Pph Medical Of Tn, Inc Dba's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Does Pph Medical Of Tn, Inc Dba hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 44D2035531) is associated with this NPI, valid through January 18, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Pph Medical Of Tn, Inc Dba was last updated on July 23, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.