LIDEADERICK LAMAR GREGORY PMHNP
NPI 1720859762
Nurse Practitioner - Psychiatric/Mental Health in Memphis, TN
About Lideaderick Lamar Gregory Pmhnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LIDEADERICK LAMAR GREGORY PMHNP (NPI 1720859762) is an individual psychiatric/mental health provider in Memphis, Tennessee, licensed in Tennessee (40177) and active in the NPI registry since January 2024. He is enrolled in Medicare PECOS and is a graduate of University Of Alabama School Of Medicine (2025).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Lideaderick Lamar Gregory Pmhnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 38128 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Lideaderick Gregory's NPI number?
The NPI number for Lideaderick Gregory is 1720859762. It was assigned to this individual provider in the NPPES registry on January 9, 2024.
Where is Lideaderick Gregory located?
Lideaderick Gregory practices at 3030 Covington Pike Ste 200, Memphis, TN 38128. The listed phone number is (901) 266-8760.
What is Lideaderick Gregory's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Lideaderick Gregory enrolled in Medicare?
Yes. Lideaderick Gregory is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Lideaderick Gregory was last updated on January 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months 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.
# Lideaderick Lamar Gregory, PMHNP · NPI 1720859762
Psychiatric/Mental Health physician in Memphis, Tennessee. Individual provider, active in the CMS NPPES registry since January 9, 2024.
## Identity
- **NPI:** 1720859762 (Entity type: Individual)
- **Enumerated:** January 9, 2024
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **State license:** 40177 (Tennessee)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 3030 COVINGTON PIKE STE 200, Memphis, TN 38128-5048
- **Phone:** (901) 266-8760
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** University Of Alabama School Of Medicine, class of 2025
## Record status
- **NPPES last updated:** January 3, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1720859762) · Data from the CMS NPPES public registry.